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Adrenal (Addisonian) crisis — DIPIMC MCQ

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HardMedical EmergenciesAdrenal (Addisonian) crisisDIPIMCDipIMC

A woman with known Addison's disease has been vomiting and is now hypotensive and drowsy. She admits to missing several steroid doses and her capillary glucose is at the low end of normal.

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

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Correct answer: B — Give intravenous or intramuscular hydrocortisone 100 mg and an intravenous fluid bolus

Explanation lettering: E = shown as C · C = shown as D · D = shown as E

An adrenal (Addisonian) crisis is treated immediately with parenteral hydrocortisone 100 mg and intravenous fluids, with glucose as needed, and treatment should not be delayed for confirmation. Withholding steroids (A) or relying on oral prednisolone with discharge (E) risks rapid deterioration. In a known Addisonian who is unwell, give hydrocortisone first and ask questions later.

Reference: JRCALC Clinical Guidelines; endocrine emergency guidance