ruhighazi
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A 24-year-old male comes to the ED in adrenal crisis. His wife reports that he has been feeling poorly for about 48 h. He is mumbling incoherently, blood pressure is
80/60, and temperature is 103°F. Which of the following actions is LEAST likely to benefit this patient initially?
(A) Starting mineralocorticoid therapy
(B) Infusing isotonic saline
(C) Administering dextrose
(D) Administering 100 to 200 mg hydrocortisone
(E) Administering appropriate intravenous
antibiotics
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Ruhighazi
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| mesh
Forum Guru
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A
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| Jinx
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e?
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| som
Forum Guru
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i guess it's E? but if the fever is the caus efor hsi adrenal crisis and the fever is frm infection yeah, he needs antibiotics to correct his underlying condition, in that case i may go with A
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| shilahk
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e...yes antibiotic is a line of therapy for acute adrenal crises but it is least important than the others...but on the other hand mineralocorticoids is deficient in part of the addison's patients not all and yes it's not as importnat as fluid resucitation...actually i am not sure which i will choose, but i am more with A as an answer
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| AAAAA
Forum Fanatic
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The correct answer is A. Yes A in acute adrenal crisis
The treatment is slightly different in acute and chronic
adrenal insufficiency.
In acute adrenal crisis, YOU DO NOT GIVE MINERALO-
CORTICOIDS.
But in chronic adrenal insufficiency, you DO give
mineralocorticorticoids : oral fludrocortisone 0.05-0.1 mg/d
This is an excellent question how to treat acute vs
chronic adrenal insuffiency.
In acute adrenal crisis, you give high dose
corticosteroid, IV fluid, but you must treat the real
underlying problem: infection, infection, infection !
Treat the infection and DIC, coagulopathy.
But in chronic adrenal insufficiency, you DON"T give
antibiotics but give fludrocortisone !
Excellent question !! A+
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| AAAAA
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Antibiotics are the most important part of treatment in acute adrenal crisis !
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| achilles
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A.
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| achilles
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good explanation AAAAA !
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| Jinx
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glad i got that wrong--ill remember it for sure now!!
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| cyra
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Awesome explaination AAAA!Thanks!
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| guayoman
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Hey AAAAA, what would be the 1st step in the management of acute and chronic adrenal insufficiency?
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