A 46-year-old woman on long-term prednisolone for lupus presents with fever, vomiting and confusion. Blood pressure is 84/48 mmHg, sodium 126 mmol/L,

Question

A 46-year-old woman on long-term prednisolone for lupus presents with fever, vomiting and confusion. Blood pressure is 84/48 mmHg, sodium 126 mmol/L, potassium 5.8 mmol/L and glucose 3.2 mmol/L. What is the most important next step?

Accepted Answer

Intravenous hydrocortisone and isotonic fluid resuscitation

Answer

Commence fludrocortisone alone

Answer

Administer insulin and dextrose as definitive therapy

Answer

Fluid restriction

Answer

Wait for morning cortisol before treatment

Adrenal crisis — RACP Written MCQ

A 46-year-old woman on long-term prednisolone for lupus presents with fever, vomiting and confusion. Blood pressure is 84/48 mmHg, sodium 126 mmol/L, potassium 5.8 mmol/L and glucose 3.2 mmol/L. What is the most important next step?