— 生理適應 · HARD · MCQ —
病患診斷為愛迪生氏症危象（Addisonian crisis）。預期出現何種電解質失衡？
A client is diagnosed with Addisonian crisis. Which electrolyte imbalance is expected?
- AHypernatremia and hypokalemia高鈉血症和低鉀血症
- BHyponatremia and hyperkalemia✓ 正解低鈉血症和高鉀血症
- CHypocalcemia and hyperphosphatemia低鈣血症和高磷血症
- DHypercalcemia and hypokalemia高鈣血症和低鉀血症
— Explanation · 中文詳解 —
愛迪生氏症是由於腎上腺皮質激素（醛固酮與皮質醇）不足。醛固酮的主要功能為保留鈉、排泄鉀。當激素缺乏時，病患會流失過多鈉離子（導致低血鈉）並堆積鉀離子（導致高血鉀）。其他選項皆不符合醛固酮缺乏的生理病理機轉。
Addison's disease results from insufficient adrenocortical hormones (aldosterone and cortisol). Aldosterone's main function is to retain sodium and excrete potassium. When the hormone is deficient, the patient loses excessive sodium ions (resulting in hyponatremia) and accumulates potassium ions (resulting in hyperkalemia). The other options do not correspond to the pathophysiologic mechanism of aldosterone deficiency.
✦ 台美臨床差異
美台臨床對愛迪生氏症的診斷與急救藥物（如 Hydrocortisone）使用一致。