Which laboratory test would be expected for a patient admitted with acute adrenal insufficiency?

Which laboratory test would be expected for a patient admitted with acute adrenal insufficiency?

• A. Sodium
• B. Cortisol
• C. Potassium
• D. Glucose

Answer: (B)

In acute adrenal insufficiency, the body cannot mount the necessary cortisol response to stress. Cortisol is the hormone that helps maintain blood pressure, supports gluconeogenesis to keep blood sugar from falling, and modulates the stress response. When the adrenal glands fail or ACTH signaling is deficient, cortisol levels become inappropriately low for the level of physiological stress. That makes measuring cortisol the most direct way to identify the problem: a low or inappropriately normal cortisol level during crisis points to adrenal insufficiency. Hyponatremia, hyperkalemia, and hypoglycemia can accompany the crisis due to the metabolic and mineralocorticoid effects, but these findings are not as specific or diagnostic as the cortisol level itself. An ACTH stimulation test may be used if cortisol results are inconclusive, but the key expected lab finding in this scenario is a low cortisol level.

In acute adrenal insufficiency, the body cannot mount the necessary cortisol response to stress. Cortisol is the hormone that helps maintain blood pressure, supports gluconeogenesis to keep blood sugar from falling, and modulates the stress response. When the adrenal glands fail or ACTH signaling is deficient, cortisol levels become inappropriately low for the level of physiological stress. That makes measuring cortisol the most direct way to identify the problem: a low or inappropriately normal cortisol level during crisis points to adrenal insufficiency.

Hyponatremia, hyperkalemia, and hypoglycemia can accompany the crisis due to the metabolic and mineralocorticoid effects, but these findings are not as specific or diagnostic as the cortisol level itself. An ACTH stimulation test may be used if cortisol results are inconclusive, but the key expected lab finding in this scenario is a low cortisol level.