Q: 54 year old male with PMH of HTN, DM, Steroid dependent COPD - is admitted to ICU with confusion, hypotension, severe vomiting and diarrhea, sudden penetrating pain in the legs, lower back and abdomen associated with Hypoglycemia, Hyponatremia, Hyperkalemia and Hypercalcemia. Your diagnosis?

A) Acute lumbar disc herniation

B) "Bleed in the head"

C) Addisonian Crisis

D) DKA (Diabetes Keto-acidosis)

Answer: Addisonian Crisis 

Adrenal crisis or Addisonian crisis is a potentially life-threatening situation requiring immediate emergent attention. Clinically it presents with constellation of symptoms caused by insufficient levels of cortisol. Suddenly stopping intake of steroids is one major cause of it.