adrenal crisis

Symptoms

  • tachycardic, hypotensive, may need pressors

Diagnosis

  • Low Na, high K
  • Na 130s, K > 5
  • Primary Adrenal Insufficiency
  • secondary adrenal insufficiency:
    • exogenous steroids
    • pituitary surgery, radiation, trauma
    • pituitary mass
    • hypophysitis: checkpoint inhibitors

Treatment

  • stress dose hydrocortisone: stress dose steroid
  • taper off as soon as possible based on clinical status
  • avoid discharging pt on exogenous steroids unless they have insufficiency