A 45-year-old woman with Addison's disease presents with diarrhoea, fever and collapse. BP is 78/42 mmHg, sodium 122 mmol/L, potassium 6.2 mmol/L and

Question

A 45-year-old woman with Addison's disease presents with diarrhoea, fever and collapse. BP is 78/42 mmHg, sodium 122 mmol/L, potassium 6.2 mmol/L and glucose 3.0 mmol/L. Her partner says she has been unable to keep tablets down for 24 hours. What is the most appropriate immediate action?

Accepted Answer

Give intravenous hydrocortisone and isotonic saline immediately

Answer

Give oral fludrocortisone as sole treatment

Answer

Restrict fluids because sodium is low

Answer

Wait for serum cortisol before steroid administration

Answer

Treat hyperkalaemia first and review later

Addisonian crisis — SCE Acute Medicine MCQ

A 45-year-old woman with Addison's disease presents with diarrhoea, fever and collapse. BP is 78/42 mmHg, sodium 122 mmol/L, potassium 6.2 mmol/L and glucose 3.0 mmol/L. Her partner says she has been unable to keep tablets down for 24 hours. What is the most appropriate immediate action?