Adrenal crisis presents with severe weakness, hypotension, and abdominal pain; initial management includes:

• A. Aggressive IV fluids, electrolyte correction, and hydrocortisone until adrenal insufficiency is ruled out
• B. Oral hydration and bed rest
• C. Insulin therapy and potassium replacements only
• D. Imaging before initiating treatment

Answer: (A)

When adrenal crisis is suspected, the priority is rapid stabilization to treat shock and the underlying hormone deficiency. Aggressive intravenous fluids restore intravascular volume and improve blood pressure, while correcting electrolyte disturbances helps prevent dangerous imbalances. Starting hydrocortisone promptly is essential because the lack of cortisol (and some mineralocorticoid activity) drives the hypotension and hyponatremia; providing hydrocortisone addresses this deficiency immediately and supports vascular tone, even before any confirmatory tests are back. You don’t wait for imaging or lab results to start treatment, since delays can be fatal and testing can follow stabilization. Oral hydration or bed rest cannot reverse the severe volume depletion and hormonal deficit, and insulin-only therapy won’t fix the underlying crisis or restore perfusion and electrolytes.