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Adrenal suppression risk — NDEB AFK MCQ

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HardBiomedical SciencesAdrenal suppression riskNDEB AFK

A 60-year-old taking chronic prednisone for polymyalgia rheumatica is scheduled for multiple extractions under local anaesthesia. He appears cushingoid and reports dizziness when doses are missed. What is the most important consideration?

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Correct answer: D — Assess adrenal suppression and surgical stress risk

Chronic systemic corticosteroid therapy can suppress the hypothalamic-pituitary-adrenal axis, so surgical stress and missed doses may precipitate adrenal insufficiency. Withholding the usual steroid dose is unsafe. The pearl is to clarify dose, duration, procedure stress, and medical advice when planning invasive dental care.

Reference: Canadian dental pharmacology references; NDEB KSAs 2024