Crunch Time Endocrine

Question 1

Physical exam findings of acute adrenal crisis

Answer 1

vital sign instability
hypoglycemia
hypotension that isn’t responsive to fluids

Question 2

Labs consistent with acute adrenal crisis

Answer 2

hyponatremia
hypokalemia

low cortisol levels
abnormal ACTH stim test

Question 3

Treatment for acute adrenal crisis

Answer 3

IVF (D5NS is fluid of choice if hypoglycemic)

hydrocortisone (100mg IV)
dexamethasone (if K is under 6); it won’t interfere with ACTH suppression tests, so use this if this is a possible new dx

pressors if needed
treat hyperK if needed