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Pathology · single question

ADDISON'S DISEASE CASE (continued): What is the best initial management for this patient in the dental setting?

  1. Administer epinephrine and call emergency services
  2. Begin dental treatment with stress reduction protocol only
  3. Administer corticosteroids immediately and proceed with treatment
  4. Refer to physician for evaluation and medical management
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Correct answer: D. Refer to physician for evaluation and medical management

If Addison's Disease is suspected (undiagnosed) in the dental office, the patient must be referred to a physician for confirmation and medical management before elective dental treatment. For a known Addison's patient undergoing stressful dental procedures, a corticosteroid supplementation (stress dose) protocol is followed — but that requires physician coordination. The immediate priority for an undiagnosed/uncontrolled patient is referral.
  • A. CORRECT. For a suspected or poorly controlled Addison's patient, referral to a physician is the priority before elective dental treatment.
  • B. Incorrect. While corticosteroid supplementation is part of the management of known Addison's patients, administering steroids without diagnosis and then proceeding with treatment is not appropriate.
  • C. Incorrect. Epinephrine is for anaphylaxis or cardiac arrest, not for Addison's disease management.
  • D. Incorrect. Stress reduction alone is insufficient — Addison's patients require corticosteroid supplementation for stressful procedures to prevent adrenal crisis.

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