Adrenal Crisis

Question 1

weakness, abdominal pain, FEVER, confusion, hypotension, dehydration, skin pigmentation, hypoglycemia are essentials of diagnosis with what condition?

Answer 1

Adrenal crisis

Question 2

what is the “general” cause of adrenal crisis?

Answer 2

insufficient mineral corticoid (aldosterone) and glucocorticoid (cortisol)

Primary- destruction of adrenal cortex

Secondary- ACTH hyposecretion (sudden withdrawal of prednisone or fludrocortisone)

Question 3

Sx of headache, lassitude, N/V, abdominal pain, diarrhea, confusion, coma, cyanosis, dehydration, axillary hair are consistent with what condition?

Answer 3

adrenal crisis

Question 4

signs of skin hyperpigmentation, fever, hyperkalemia, hyponatremia, hypotension, eosinophilia are associated with what type of condition?

Answer 4

adrenal crisis

Question 5

what kind of lab/imaging findings will you have with adrenal crisis?

Answer 5

Eosinophils will be high

hypoglycemia

hyponatremia/hyperkalemia

blood, sputum, and urine may be + for bacteria

Question 6

what is the diagnostic test for adrenal crisis

Answer 6

cosyntropin stimulaiton test with serum ACTH level

early morning serum cortisol

Question 7

DDX of acute adrenal insufficiency

Answer 7

shock
hyperkalemia
hyponatremia
or acute abdomen

Question 8

Treatment for Adrenal crisis

Answer 8

hydrocortisone 100-300 mg IV and saline (immediately)

then tapered off.

Question 9

what are some labs/screening to run with suspected adrenal crisis?

Answer 9

electrolytes, cortisol, ACTH

ensure they have been compliant with prescribed mineralocorticoid/glucocorticoid

screen for infection