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Fluid refractory hypotensive shock. Endocrinology.

25-year male presents with several days history of fatigue, nausea and vomiting. An initial broad differential needs to be explored including the use of bedside US to investigate possible causes of shock. Patient presents initially as possible septic shock or hypovolemic shock, however no obvious source of sepsis and fluid refractory shock. Learner is required to look for alternative reasons for the hypotensive state which includes severe acute adrenocortical insufficiency.

Goals and Objectives

Objectives (Medical and CRM):

  • General approach to hypotensive shock.
  • Approach to fluid resistant shock.
  • Recognition and Management of Adrenal Crisis.


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