Adrenal crisis is suspected when a patient with Addison disease presents with:

Adrenal crisis is suspected when a patient with Addison disease presents with:

• A. Hypertension and Abdominal Pain
• B. Confusion and Tachycardia
• C. Bradycardia and Nausea
• D. Widening Pulse Pressure and Shortness of Breath

Answer: (B)

In Addison disease, an adrenal crisis presents with acute shock features from a sudden lack of cortisol and aldosterone, leading to marked volume depletion, electrolyte disturbances, and hypoperfusion. The combination of confusion (altered mental status from reduced brain perfusion) and tachycardia (the heart’s compensatory response to hypotension and reduced circulating volume) best matches this crisis situation. Hypertension is not typical in adrenal crisis because these patients are volume depleted with low vascular tone. Bradycardia is also unlikely in this acute stress state, and signs like widened pulse pressure with shortness of breath are not as characteristic as the CNS change plus rapid pulse.

In Addison disease, an adrenal crisis presents with acute shock features from a sudden lack of cortisol and aldosterone, leading to marked volume depletion, electrolyte disturbances, and hypoperfusion. The combination of confusion (altered mental status from reduced brain perfusion) and tachycardia (the heart’s compensatory response to hypotension and reduced circulating volume) best matches this crisis situation. Hypertension is not typical in adrenal crisis because these patients are volume depleted with low vascular tone. Bradycardia is also unlikely in this acute stress state, and signs like widened pulse pressure with shortness of breath are not as characteristic as the CNS change plus rapid pulse.