A 58-year-old woman on ICU develops acute adrenal crisis following abrupt discontinuation of dexamethasone that had been prescribed for 3 weeks for ce...

Question

A 58-year-old woman on ICU develops acute adrenal crisis following abrupt discontinuation of dexamethasone that had been prescribed for 3 weeks for cerebral oedema. She presents with hypotension (BP 70/40), hypoglycaemia (BGL 2.1 mmol/L), nausea, and confusion. What is the immediate treatment?

Accepted Answer

IV hydrocortisone 100 mg bolus, followed by 50 mg QDS, with IV fluids and glucose correction

Answer

Restart dexamethasone at the previous dose

Answer

IV fludrocortisone 100 mcg

Answer

IM ACTH (Synacthen) to stimulate adrenal recovery

Answer

Oral prednisolone 40 mg

uk-fficm MCQ (SBA): Acute Adrenal Crisis

A 58-year-old woman on ICU develops acute adrenal crisis following abrupt discontinuation of dexamethasone that had been prescribed for 3 weeks for cerebral oedema. She presents with hypotension (BP 70/40), hypoglycaemia (BGL 2.1 mmol/L), nausea, and confusion. What is the immediate treatment?