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Question 14
•A 24 year old male comes to the ED in adrenal crisis. His wife reports that he has been feeling poorly for about 48 h. He is mumbling incoherently, BP: 80/60, and T: 39°c. Which of the following actions is LEAST likely to benefit this patient initially?
A.Starting mineralocorticoid therapy
B.Infusing isotonic saline
C.Administering dextrose
D.Administering 100 to 200 mg hydrocortisone
E.Administering appropriate intravenous antibiotics
Answer & Comments
•A
Comments:
–This patient’s initial stabilization should include all of these measures except beginning mineralocorticoid therapy.
–Hydrocortisone replenishes the patient’s inadequate steroid levels and provides some mineralocorticoid effect. Therefore, early administration of mineralocorticoids is not necessary.
–Correction of hypoglycemia and hypotension are essential.
–Early antibiotic administration is important to prevent potentially fatal infections leading to adrenal crisis.
•A 24 year old male comes to the ED in adrenal crisis. His wife reports that he has been feeling poorly for about 48 h. He is mumbling incoherently, BP: 80/60, and T: 39°c. Which of the following actions is LEAST likely to benefit this patient initially?
A.Starting mineralocorticoid therapy
B.Infusing isotonic saline
C.Administering dextrose
D.Administering 100 to 200 mg hydrocortisone
E.Administering appropriate intravenous antibiotics
Answer & Comments
•A
Comments:
–This patient’s initial stabilization should include all of these measures except beginning mineralocorticoid therapy.
–Hydrocortisone replenishes the patient’s inadequate steroid levels and provides some mineralocorticoid effect. Therefore, early administration of mineralocorticoids is not necessary.
–Correction of hypoglycemia and hypotension are essential.
–Early antibiotic administration is important to prevent potentially fatal infections leading to adrenal crisis.
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