A 47-year-old woman is hospitalized for pyelonephritis. The patient has a 6-year history of primary adrenal insufficiency and has been doing well on oral hydrocortisone and fludrocortisone. She reports missing two doses of the hydrocortisone today because of nausea. She is started on rapid intravenous infusion of normal saline and ceftriaxone. On examination, temperature is 38.9°C, blood pressure is 92/58 mm Hg supine and 76/50 mm Hg sitting pulse rate is 98/min supine and 112/min sitting, and respiration rate is 19/min. Her serum sodium level is 125 meg/L and a serum potassium level ist5.5 meg/L. Which of the following should be administered next?
سؤال مجاني 10 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Stress dosage of intravenous hydrocortisone
A patient with known primary adrenal insufficiency who misses hydrocortisone during an infection and becomes hypotensive with hyponatraemia and hyperkalaemia is in adrenal crisis. Treatment is IV stress-dose hydrocortisone (e.g. 100 mg IV every 8 h) plus normal saline. Usual oral doses or fludrocortisone alone are not enough, and 3% saline does not address the cortisol deficiency.
- المصدر
- Adrenal disorders (2).pdf · p. 6
- المحاضرة
- Adrenal Crisis · Endocrinology · Module B
- ظهر في
- Endo bank