Professional and Linguistic Assessments Board (PLAB) Practice Exam

What triad of lab findings may indicate an adrenal crisis?

1. Hyponatremia, Hyperglycemia, + Hypokalemia

2. Hyponatremia, Hypoglycemia, + Hyperkalemia

3. Hypernatremia, Hypoglycemia, + Hypocalcemia

4. Hyponatremia, Hyperglycemia, + Hypocalcemia

The correct answer is: Hyponatremia, Hypoglycemia, + Hyperkalemia

In an adrenal crisis, the triad of lab findings indicative of this life-threatening condition typically includes hyponatremia, hypoglycemia, and hyperkalemia. Hyponatremia refers to a low sodium level in the blood, which can occur when there is insufficient aldosterone production from the adrenal glands. Aldosterone normally helps regulate sodium and potassium levels, so a deficiency can lead to sodium being lost from the body. Hypoglycemia, or low blood glucose levels, is also a significant factor during an adrenal crisis. Cortisol, produced by the adrenal glands, plays a crucial role in glucose metabolism. In the absence of adequate cortisol, blood sugar levels can drop, leading to hypoglycemia. Hyperkalemia, or elevated potassium levels, often arises due to reduced aldosterone secretion, which normally promotes potassium excretion. During an adrenal crisis, the failure to produce enough aldosterone means that potassium can accumulate in the bloodstream. This combination of findings is particularly reflective of adrenal insufficiency during a crisis, making it crucial for prompt recognition and management. The other options do not present this correct combination of lab findings relevant to an adrenal crisis scenario.