Corticosteroids

Question 1

If a patient is has gone undiagnosed or not presented with symptoms of adrenal insufficiency can present with adrenal crisis, which is a medical emergency of low cortisol levels. What corticosteroid medication should patients be prescribed intravenously?

1 - Testosterone
2 - Hydrocortisone
3 - Fludrocortisone
4 - Prednisolone

Answer 1

2 - Hydrocortisone

• alongside intravenous fluids and hypoglycaemia management
• in primary adrenal insufficiency, mineralocorticoid and glucocorticoid are reduced. When glucocorticoid dose < 50mg/24 hr, fludrocortisone treatment should be started at 100mcg once daily)

Question 2

What is a hydrocortisone emergency injection kit used for?

1 - kit used for diabetic ketoacidosis
2 - kit used for lactic acidosis
3 - kit for renal crisis
4 - kit for adrenal crisis

Answer 2

4 - adrenal crisis

• patient will be vomiting or dehydrated
• main component is 3 vials of hydrocortisone phosphate (100mg/ml)

Question 3

If patients are diagnosed with adrenal insufficiency, they need to be prescribed a steroid to mimic the lost steroid. What is the long term treatment patients should be given?

1 - Testosterone
2 - Hydrocortisone
3 - Fludrocortisone
4 - Prednisolone

Answer 3

3 - Fluorocortisone