Practise 40 single best answer questions on endocrinology for the MRCEM SBA exam. Every question comes with a detailed explanation, so you learn why the right answer is right and why the others are wrong.
Endocrine emergencies are easy to miss and quick to kill. Questions test DKA and HHS management, adrenal crisis and electrolyte disturbances.
A 74-year-old woman on long-term prednisolone for polymyalgia rheumatica stopped it abruptly 3 days ago. She is confused, with BP 80/50 mmHg, HR 48, temperature 34°C, glucose 3.0 mmol/L and sodium 124 mmol/L.
What is the most likely diagnosis?
A. Myxoedema coma
B. Adrenal crisis caused by steroid withdrawal
C. Septic shock
D. Hypothermia from exposure
E. Schmidt's syndrome
Answer: B. Stopping long-term steroids suddenly leaves the suppressed adrenal glands unable to respond. The result is shock, hypoglycaemia and hyponatraemia, which need immediate IV hydrocortisone.
Try 20 free sample questions to see the style and explanations, then choose the plan that suits you.