QuestionSBA
QuestionChoice
This patient has Addison's disease. When patients with Addison's disease have a concurrent illness their hydrocortisone dose should be doubled whilst their fludrocortisone dose should remain unchanged.
50456
c
Increase her hydrocortisone to 40mg PO BD and increase her fludrocortisone dose to 100 micrograms PO OD
QuestionChoice
This patient has Addison's disease. When patients with Addison's disease have a concurrent illness their hydrocortisone dose should be doubled whilst their fludrocortisone dose should remain unchanged.
50454
a
Increase her hydrocortisone to 40mg PO BD, don't change her fludrocortisone dose
QuestionChoice
This patient has Addison's disease and will be steroid dependent. Her corticosteroid and mineralocorticosteroid medications must not be stopped.
50458
e
Stop both her hydrocortisone and fludrocortisone immediately
QuestionChoice
This patient has Addison's disease. When patients with Addison's disease have a concurrent illness their hydrocortisone dose should be doubled whilst their fludrocortisone dose should remain unchanged.
50455
b
Increase her fludrocortisone dose to 100 micrograms PO OD, do not change her hydrocortisone dose
QuestionChoice
This patient has Addison's disease. When patients with Addison's disease have a concurrent illness their hydrocortisone dose should be doubled whilst their fludrocortisone dose should remain unchanged.
50457
d
Make no changes to her medications
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3674
Sick day rules in patients with Addison's disease
Topic
9
Internal Medicine
10145
Case Presentation:  A 48-year-old woman is attends her GP due to an ongoing cough. She has had this cough for the last 2 days. It is productive of green sputum. She has also been experiencing feverish symptoms since her cough started.


**PMH** Addison's disease

**DH** Hydrocortisone 20mg PO BD, Fludrocortisone 50 micrograms PO OD

Question: Select the most appropriate decision option based on this data
a