skip to main content

Adrenal crisis — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

EasyAdrenalAdrenal crisisSCE Endocrinology

A 58-year-old man on long-term prednisolone for vasculitis is admitted with vomiting, fever and confusion. Blood pressure is 78/46 mmHg, sodium is 129 mmol/L and glucose is 3.2 mmol/L. He cannot keep tablets down. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Give immediate intravenous or intramuscular hydrocortisone with rapid 0.9% saline

Suspected adrenal crisis is treated immediately; diagnostic testing must not delay hydrocortisone and isotonic fluid resuscitation. Fludrocortisone alone is inadequate in shock. The pearl is that short-term high-dose hydrocortisone is safer than missed adrenal crisis treatment.

Reference: Society for Endocrinology adrenal crisis guidance