Adrenal Disorders USMLE Step 1 Practice Question
A 63-year-old woman with a history of lung cancer presents with sudden onset severe back pain, hypotension (BP 85/50 mmHg), and altered mental status. She is found to have Na+ 128 mEq/L, K+ 6.2 mEq/L, and cortisol 4 µg/dL. Non-contrast CT abdomen shows bilateral adrenal masses with hemorrhage. Which of the following is the most appropriate immediate treatment?
Answer choices
- AStart chemotherapy for metastatic disease
- BPerform emergent adrenalectomy
- CStart spironolactone for hyperkalemia
- DAdminister dexamethasone and schedule imaging
- EImmediate IV hydrocortisone, fluid resuscitation, and vasopressorsCorrect answer
- FInitiate insulin and glucose infusion for hyperkalemia management alone
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