In this patient, what is the most appropriate initial management step?

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Multiple Choice

In this patient, what is the most appropriate initial management step?

In suspected adrenal crisis, replacing the missing cortisol promptly is the most important step for stabilizing the patient. Hydrocortisone provides both glucocorticoid and some mineralocorticoid activity, which helps restore vascular tone and improve blood pressure that’s not fully responsive to fluids or catecholamines. This early steroid replacement tackles the core problem driving the shock, so it’s prioritized even as you begin supportive measures like IV fluids. Giving IV fluids is essential to support circulation, and glucose is important if there’s hypoglycemia, but neither addresses the underlying cortisol deficiency as directly and urgently as hydrocortisone. Naloxone targets opioid overdose and isn’t indicated here.

In suspected adrenal crisis, replacing the missing cortisol promptly is the most important step for stabilizing the patient. Hydrocortisone provides both glucocorticoid and some mineralocorticoid activity, which helps restore vascular tone and improve blood pressure that’s not fully responsive to fluids or catecholamines. This early steroid replacement tackles the core problem driving the shock, so it’s prioritized even as you begin supportive measures like IV fluids.

Giving IV fluids is essential to support circulation, and glucose is important if there’s hypoglycemia, but neither addresses the underlying cortisol deficiency as directly and urgently as hydrocortisone. Naloxone targets opioid overdose and isn’t indicated here.

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