Adrenal Insufficiency Guideline Quiz

A 30-year-old male with primary adrenal insufficiency presents for genetic counseling. What type of PAI is inherited in an autosomal recessive pattern?

A 45-year-old female with primary adrenal insufficiency is diagnosed with autoimmune gastritis with vitamin B12 deficiency. What additional testing should be done during her annual evaluation?

A 10-year-old male with primary adrenal insufficiency presents for his annual follow-up appointment. What should be evaluated during this visit?

A 35-year-old female with a history of primary adrenal insufficiency presents to the emergency department with severe abdominal pain and vomiting. What is the appropriate management in this situation?

What is the recommended best practice statement for the prevention of adrenal crisis in patients with primary adrenal insufficiency?

What is the recommended duration of oral glucocorticoid dose at double or triple the usual daily dose for patients with primary adrenal insufficiency during febrile illness?

In the absence of hydrocortisone, what glucocorticoid is suggested as an alternative for the treatment of adrenal crisis?

A patient with known primary adrenal insufficiency presents to the emergency department with symptoms of an adrenal crisis. What is the recommended immediate parenteral injection dose of hydrocortisone for adults?

A 10-year-old girl with PAI presents to the clinic for a routine follow-up visit. She has been stable on hydrocortisone 10 mg/m2/day for the past year. She reports feeling well and has no recent illness or stressors. Her blood pressure is 110/70 mmHg, and her laboratory tests show a normal serum sodium level. What is the appropriate management for this patient?

A 16-year-old girl with PAI presents to her endocrinologist for a routine follow-up visit. She reports feeling well and has not experienced any recent illness or stressors. What is the appropriate monitoring for this patient?

A 6-year-old boy presents to the emergency department with vomiting, diarrhea, and lethargy. He has a history of PAI and has missed his morning hydrocortisone dose. He is hypotensive, and his laboratory tests show hyponatremia and hyperkalemia. What is the appropriate initial Treatment for this patient?

What is the recommended monitoring for children with PAI receiving glucocorticoid replacement therapy?

An infant with PAI and confirmed aldosterone deficiency is being treated with mineralocorticoid replacement therapy. What is the recommended medication?

A 6-year-old child with PAI is being treated with glucocorticoid replacement therapy. What is the recommended medication?

A pregnant woman with PAI is receiving hydrocortisone replacement therapy. What is the recommended approach for dose adjustment during the third trimester of pregnancy?

A 30-year-old woman with adrenal insufficiency presents with reduced energy levels, depression, and anxiety despite optimized glucocorticoid and mineralocorticoid replacement. What is the recommended treatment?

A 30-year-old woman with PAI is on glucocorticoid and mineralocorticoid replacement therapy. She is pregnant and in the third trimester. Which of the following is recommended for optimizing glucocorticoid replacement therapy during pregnancy?

A 24-year-old woman presents with primary adrenal insufficiency (PAI) and low energy levels. She is on optimized glucocorticoid and mineralocorticoid replacement therapy. Which of the following is true regarding DHEA replacement in this patient?

A 40-year-old female with primary adrenal insufficiency (PAI) reports low libido and low energy levels despite optimized glucocorticoid and mineralocorticoid replacement therapy. What is the recommended next step?

A 25-year-old male with PAI is started on fludrocortisone replacement therapy. After several weeks, the patient develops hypertension. What is the recommended next step?

A 10-year-old child presents with failure to thrive, fatigue, and anemia. Upon examination, the child has increased pigmentation of the skin and mucous membranes. Laboratory tests reveal hyponatremia and hyperkalemia. Which of the following is the most likely diagnosis?

A 45-year-old female with primary adrenal insufficiency (PAI) is started on fludrocortisone replacement therapy. Which of the following is NOT recommended for assessing adequate mineralocorticoid replacement?

What is the recommended method for monitoring glucocorticoid replacement?

Which dosing regimen of hydrocortisone is recommended to mimic the physiological circadian rhythm?

Which of the following is the recommended glucocorticoid therapy for all patients with confirmed primary adrenal insufficiency (PAI)?

A 50-year-old man with chronic liver disease presents with fatigue and weight loss. Which of the following tests would be most appropriate for the diagnosis of adrenal insufficiency in this patient?

A 35-year-old woman with autoimmune thyroiditis presents with fatigue and weight loss. She has a positive history of autoimmunity in her family. Which of the following tests is most appropriate for the diagnosis of adrenal insufficiency in this patient?

A 45-year-old man presents with fatigue and weight loss. He has a history of pituitary tumor resection 5 years prior. Which of the following tests would be the most appropriate initial screening test for adrenal insufficiency in this patient?

A 28-year-old pregnant woman presents with weakness, hypotension, and nausea. Which of the following is the most appropriate diagnostic test for primary adrenal insufficiency in pregnancy?

A 35-year-old man with type 1 diabetes mellitus presents with weakness, abdominal pain, and hyperpigmentation of the skin. Which of the following is the most likely cause of his primary adrenal insufficiency?

A 27-year-old woman presents with fatigue, musculoskeletal pain, and weight loss. Laboratory testing reveals a low morning cortisol concentration and an elevated ACTH concentration. Which of the following is the most appropriate confirmatory test for primary adrenal insufficiency (PAI)?

A 45-year-old man presents to the emergency department with hypotension, hyperkalemia, and hyponatremia. What is the most appropriate initial treatment while awaiting diagnostic testing for primary adrenal insufficiency?

A 32-year-old woman presents with weakness, fatigue, and abdominal pain. Physical examination reveals hyperpigmentation of sun-exposed areas, skin creases, mucosal membranes, and scars. Which of the following is the most appropriate diagnostic test for primary adrenal insufficiency (PAI)?

A 28-year-old man presents with complaints of fatigue, weakness, and abdominal pain. He reports a history of tuberculosis, for which he completed Treatment 6 months ago. On physical examination, he appears dehydrated and has hyperpigmentation of his skin and mucous membranes. Blood tests reveal low sodium, high potassium, and low morning cortisol levels. Which of the following is the most likely cause of his adrenal insufficiency?

A 36-year-old woman presents to the emergency department with complaints of severe fatigue, nausea, and abdominal pain. She reports a history of autoimmune disease and has been taking long-term glucocorticoid therapy. On physical examination, she appears dehydrated and has hyperpigmentation of her skin and mucous membranes. Blood tests reveal low sodium, high potassium, and low morning cortisol levels. What is the most appropriate next step in diagnosing this patient’s condition?

A 25-year-old male presents with severe weakness, syncope, and abdominal pain. Upon examination, his blood pressure is low, and he has marked tenderness in his abdomen. Laboratory tests reveal hyponatremia, hyperkalemia, and hypoglycemia. What is the most likely diagnosis?

A 35-year-old female presents with fatigue, weight loss, and abdominal discomfort. She reports having salt cravings and has noticed increased pigmentation of her skin. Her blood pressure is low, with an increased drop upon standing. Which of the following is the most likely diagnosis?

A 10-year-old girl presents to the pediatrician with complaints of weakness, fatigue, and weight loss. On physical examination, she has hyperpigmentation of her skin and mucous membranes and has lost axillary and pubic hair. Blood tests reveal low sodium, high potassium, and low morning cortisol levels. Which of the following is the most appropriate initial diagnostic test for this patient?