An 18 years old male underwent bilateral Adrenalectomy for bilateral pheocytochromas. 48 hours following surgery He is feeling lethargic and very tired. His Blood pressure is 80/60 mmHg and his pulse Rate 90/mins. Clinical examination doesn’t Reveal any sign of volume loss. The most Likely diagnosis is:
A. Sepsis
B. Cardiogenic shock
C. Addisonian crises
D. Hypovolumeic shock
The patient's presentation of lethargy, extreme fatigue, hypotension (blood pressure 80/60 mmHg), and tachycardia (pulse rate 90/min) following bilateral adrenalectomy suggests an acute adrenal insufficiency, known as Addisonian crisis. Bilateral adrenalectomy results in the sudden cessation of adrenal hormone production, leading to adrenal crisis.
In Addisonian crisis, the adrenal glands fail to produce adequate amounts of cortisol and aldosterone, resulting in hypotension, electrolyte imbalances, and dehydration. The symptoms of lethargy, fatigue, and hypotension, along with the absence of signs of volume loss, are classic features of Addisonian crisis.
Option A: Sepsis typically presents with fever, tachycardia, hypotension, and signs of infection, which are not prominent in this case.
Option B: Cardiogenic shock usually involves signs of heart failure and decreased cardiac output, which are not evident in this patient's presentation.
Option D: Hypovolemic shock results from volume loss due to hemorrhage or dehydration, neither of which are apparent in this case.
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