Case 29

Question 1

Where are steroids naturally produced, and what type of steroids are they?

Question 2

2.What are the physiologic effects of glucocorticosteroids?

Question 3

3.What steroids are available for administration, and what are their equivalent doses?

Question 4

4.How much cortisol is normally produced, and what is Addison disease?

Question 5

5.What are Cushing syndrome and Cushing disease?

Question 6

6.Does this patient require “stress” dose steroids?

Question 7

7.What is a stress dose of steroids; do you need to add mineralocorticoids?

Question 8

8.How long after discontinuation of steroids should a patient be considered adrenally suppressed and treated accordingly?

Question 9

9.What clinical scenarios frequently require steroid administration?

Question 10

10.How is adrenal reserve evaluated?

Question 11

11.If this patient develops septic shock from a bile leak in the postanesthesia care unit, should steroids be withheld or administered?

Question 12

12.What is the duration of steroid treatment for critical illness related to corticosteroid insufficiency?

Question 13

13.If etomidate was used in this patient, is steroid replacement warranted?