Adrenal Crisis in Emergency Medicine Questions & Answers

Updated: Oct 10, 2022
  • Author: Kevin M Klauer, DO, EJD, FACEP; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Questions & Answers

Overview

What is an adrenal crisis?

What is the difference between primary and secondary adrenocortical insufficiency in adrenal crisis?

How does hypopituitarism contribute to adrenal crisis?

What is the importance of early and accurate diagnosis of adrenal crisis?

What is the normal function of the adrenal medullae and adrenal cortex?

What are the physiologic effects of glucocorticoids relative to adrenal crisis?

What are the physiologic effects of aldosterone and how does dysfunction contribute to adrenal crisis?

What causes primary adrenal insufficiency?

What causes secondary adrenal insufficiency?

What causes acute adrenal insufficiency?

How common is adrenocortical insufficiency in the US?

What is the international incidence of adrenal crisis?

What is the mortality of acute adrenocortical insufficiency?

Is idiopathic autoimmune adrenal insufficiency more common in men or women?

At what age is idiopathic autoimmune adrenal insufficiency most commonly diagnosed?

Presentation

What are the notable features in the history of patients with adrenal crisis?

What are the physical findings in patients with adrenal insufficiency or crisis?

What are the causes and related conditions associated with adrenal crisis?

DDX

What is the relationship between etomidate and adrenal crisis?

What are the differential diagnoses for Adrenal Crisis in Emergency Medicine?

Workup

Which lab studies are indicated in suspected adrenal crisis?

Which imaging studies are indicated in suspected adrenal crisis?

Which additional tests are indicated in the workup of adrenal crisis?

Treatment

What is the emergency department treatment of adrenal crisis?

Which specialist consultations are indicated in suspected adrenal crisis?

What are the monitoring procedures for patients with adrenal crisis?

Guidelines

What are the Society for Endocrinology’s diagnostic recommendations for adrenal crisis?

What are the Society for Endocrinology’s recommendations for emergency treatment of adrenal crisis?

What are the guidelines on the workup and treatment for critical illness–related corticosteroid insufficiency (CIRCI), and what are the guidelines regarding which patients are at risk for adrenal crisis?

Medications

What are the goals of treating adrenal insufficiency and crisis?

Which medications in the drug class Corticosteroids are used in the treatment of Adrenal Crisis in Emergency Medicine?