Dental OSCE (Objective Structured Clinical Examination) Practice Exam

Which of the following statements is true regarding Adrenal crisis in patients taking corticosteroids?

1. It can be triggered by stress

2. It is only seen in diabetic patients

3. It presents as a fever

4. It requires immediate hospitalization

The correct answer is: It can be triggered by stress

The statement that adrenal crisis in patients taking corticosteroids can be triggered by stress is supported by the understanding of how corticosteroid therapy affects the hypothalamic-pituitary-adrenal (HPA) axis. When a patient is on long-term corticosteroid treatment, the body may become dependent on these external steroids for normal function. Any form of physical or emotional stress—such as surgery, infection, or significant illness—can overwhelm the body's ability to produce sufficient endogenous cortisol, leading to an adrenal crisis. Patients who have been on corticosteroids may not have the necessary cortisol response to cope with stressors, resulting in symptoms like severe fatigue, hypotension, and possibly altered mental status. It’s crucial for healthcare providers to be aware of this risk and to take appropriate measures, such as adjusting corticosteroid doses during times of stress, to prevent an adrenal crisis. The other statements do not accurately represent the facts surrounding adrenal crisis. It is not solely observed in diabetic patients, it does not primarily present as a fever, and while immediate management is critical, hospitalization is not always the first step depending on the severity of the crisis and the context of the situation. The emphasis on stress as a triggering factor is well-established in clinical practice and is a vital