Adrenal Crisis

Question 1

presentation of adrenal crisis?

Answer 1

reduced consciousness, hypotension, hypoglycaemia, hyperkalaemia, hyponatraemia

Question 2

what can adrenal crisis be due to?

Answer 2

first presentation of Addison’s disease or triggered by infection, trauma or other acute illness in someone with established Addison’s. It can also occur in patients on long term steroids that have suppressed their natural steroid production, if that patient stops taking the steroids abruptly.

Question 3

management of addisonian crisis?

Answer 3

parenteral steroids (IV hydrocortisone 100mg) 6 hourly, IV fluid resuscitation (1 litre saline 30-60 mins), correct hypoglycaemia (dextrose), careful monitoring of electrolytes and fluid balance.
oral replacement after 24 hours and be reduced to maintenance over 3-4 days

Question 4

causes of adrenal crisis?

Answer 4

sepsis, surgery, adrenal haemorrhage, steroid withdrawal