Critical Care High Yield

Question 1

What is Acute Adrenaocortical Insufficiency

Answer 1

Sudden worsening of adrenal insufficiency due to a “stressful” event (surgery, trauma, volume loss)
Patient can’t produce Cortisol to respond to stress

Question 2

What is a normal response to stress

Answer 2

3x increase in Cortisol

Question 3

What is another name for Adrenocortical Insufficiency

Answer 3

Addison’s Diasese

Question 4

What are causes of Adrenocrotical Insufficiency

Answer 4

Abrupt withdrawal of steroids

Previously undiagnosed Addisons when subjected to stress

Question 5

Sx of Adrenocortical Insufficiency

Answer 5

Shock: Reduced BP

Hypotension, Hypovolemia

Question 6

Dx of Adrenocortical Insufficiency

Answer 6

Hyperkalemia
Hyponatremia
Hypoglycemia

Question 7

Tx of Adrenocortical Insufficiency

Answer 7

IV fluids (NS to correct hypotension, D5NS if hypoglycemic)
Glucocorticoids (Dexamethasone if undiagnosed, Hydrocortisone if known Addisons)
Reversal of electrolyte abnormalities
Fludrocortison