Adrenal crisis

Question 1

What is adrenal crisis also known as acute adrenal insufficiency?

Answer 1

Potentially life-threatening emergency which occurs as a result of cortisol deficiency.

Question 2

What are the main causes of adrenal crisis?

Answer 2

• Infection - suddenly stopping chronic glucocorticoid therapy - failure to increase glucocorticoid dose to an intercurrent illness after trauma or during surgery

Question 3

What are the symptoms and signs of an adrenal crisis?

Answer 3

• Fatigue, dizziness and hypotension especially postural hypotension - collapse including hypovolaemic shock - abdominal pain, nausea, vomiting, weight loss - fever, confusion, delirium - Altered pigmentation: primary: hyperpigmentation, secondary: pale

Question 4

What is the management of adrenal crisis? In summary

Answer 4

Assess blood pressure and fluids, take history and check for glucocorticoid, take blood, give 0.9% saline and hydrocortisone, identify causes