A 50-year-old female on long-term oral prednisolone for polymyalgia rheumatica presents with increasing confusion, abdominal pain, and hypotension (BP...

Question

A 50-year-old female on long-term oral prednisolone for polymyalgia rheumatica presents with increasing confusion, abdominal pain, and hypotension (BP 75/45 mmHg) following a urinary tract infection. She has not been taking her prednisolone for the last 3 days because she felt unwell. What has precipitated the acute deterioration?

Accepted Answer

Adrenal crisis precipitated by infection in a patient with hypothalamic-pituitary-adrenal (HPA) axis suppression from chronic steroid use who has stopped her steroids

Answer

Drug interaction between prednisolone and UTI antibiotics

Answer

Septic shock from the UTI alone

Answer

Prednisolone overdose from accidental double-dosing

Answer

Steroid withdrawal headache

uk-dipimc MCQ (SBA): Adrenal Crisis from Steroid Cessation