菜单
Administers immediate parenteral injection of 50–100 mg hydrocortisone for suspected adrenal crisis secondary to adrenal insufficiency. Triggers include hypotension, hypoglycemia, or acute illness in a patient with known adrenal insufficiency.
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For a person with confirmed islet autoantibodies (early-stage type 1 diabetes), state the numerical progression risk to Stage 3 T1D by stage and age, set the age-stratified monitoring frequency (metabolic and HbA1c), apply the ≥10% longitudinal HbA1c rise → OGTT rule, and give the standard risk-modifier and communication framing. Use when a clinician asks how often should I monitor this Stage 1 child, what's the risk of this teenager progressing to insulin, adult with GAD positive what's the 5-year risk, my patient's HbA1c has risen 12% is that important, single autoantibody how often to retest, or how to counsel a family about progression risk. Grounded in Phillip et al. Diabetologia 2024 international staging and monitoring consensus, cross-referenced with Hussain et al 2026 IDF Europe roadmap.
Order and confirm islet autoantibody screening for early-stage type 1 diabetes — which antibodies to test (GAD65, IAA, IA2, ZnT8), sample types (capillary dried blood spot, venous), the mandatory two-sample two-method confirmation protocol, and how to interpret a positive, negative, or single-antibody result. Use when a clinician asks how to screen for early T1D, which islet autoantibodies to order, how to confirm a positive T1D antibody screen, is one autoantibody enough for T1D diagnosis, GAD antibody positive what next, or is running a general population or family-history T1D screening program. Grounded in Hussain et al 2026 (Diabetes, Obesity and Metabolism, IDF Europe consensus, DOI 10.1111/dom.70569).
Classify a person with a positive islet autoantibody screen into a specific stage of type 1 diabetes (At Risk / Stage 1 / Stage 2a / Stage 2b / Stage 3a / Stage 3b / Stage 4) using the international consensus staging framework based on autoantibody count and glycaemic status. Use when a clinician asks how to stage a positive autoantibody screen, what stage of T1D is this, is this early-stage T1D, does this child need insulin yet, is this presymptomatic T1D, does this qualify for teplizumab, or presents a person with any combination of islet autoantibodies + glucose data. Applies across paediatric and adult populations. Grounded in Hussain et al 2026 (Diabetes, Obesity and Metabolism, IDF Europe consensus, DOI 10.1111/dom.70569).
| name | ata-adrenal-crisis-treatment |
| description | Administers immediate parenteral injection of 50–100 mg hydrocortisone for suspected adrenal crisis secondary to adrenal insufficiency. Triggers include hypotension, hypoglycemia, or acute illness in a patient with known adrenal insufficiency. |
Collect history of adrenal insufficiency (especially secondary/pituitary origin), recent stressors (illness, surgery, trauma), current medications (glucocorticoid use), and assess for hypotension, hypoglycemia, fatigue, nausea, or abdominal pain. Measure vital signs and point-of-care glucose if available. If hypotension, hypoglycemia, or acute illness is present in a patient with known adrenal insufficiency, proceed to Step 2; otherwise, consider alternative diagnoses.
Is adrenal crisis suspected based on the triad of hypotension, hypoglycemia, or acute illness in a patient with adrenal insufficiency?
Stratify by hemodynamic severity: systolic BP <90 mmHg, altered mental status, or ongoing shock vs stable vitals.
Give the selected dose of hydrocortisone via immediate intravenous or intramuscular injection; repeat dose if no clinical improvement within 15–20 minutes and consider continuous infusion if refractory.
Do not delay treatment for confirmatory testing; avoid oral hydrocortisone if vomiting or impaired consciousness; do not use fludrocortisone in secondary AI; ensure fluid resuscitation with isotonic crystalloids; monitor for hypoglycemia and hyperglycemia after steroid administration; consider sepsis or myocardial infarction as mimics that also require urgent hydrocortisone.
A 45-year-old woman with known hypopituitarism presents with fever, systolic BP 85/50 mmHg, and glucose 45 mg/dL. She receives 100 mg hydrocortisone IV immediately, followed by fluid resuscitation; blood pressure improves to 110/70 mmHg within 30 minutes.
Source: Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI:10.1210/jc.2016-2118