観光旅行中に倒れたという外国人女性が救急車で搬入された。大きく呼びかけるとかすかに目を開くが意思の疎通は取れない。同行の友人によると持病があるとのことで、女性のかかりつけ医から預かった手紙を差し出した。
To whom it may concern:
This is to inform you that Ms.■■■ (Birth Date 3/14/1998) has 21-hydroxylase deficiency. Her condition has been well-controlled with 9 alpha-fludrocortisone and hydrocortisone. Although she does not experience any problems during her daily activities, there is a small but certain possibility that she falls into a state of adrenal failure, especially if she is confronted with severe stress on her week-long trip to Japan.
If she complains of severe fatigue, fever, anorexia, or is found unconscious, please give her intravenous hydrocortisone and sodium-containing fluid, and contact an endocrinologist immediately.
Thank you for your cooperation.
■■■, M.D.
■■■ Clinic
まず行うべき処置はどれか。
副腎皮質ステロイドの静注と乳酸リンゲル液の点滴静注
副腎皮質ステロイドの静注と5％ブドウ糖液の点滴静注
20％ブドウ糖液の静注と5％ブドウ糖液の点滴静注
アドレナリンの皮下注と生理食塩液の点滴静注
アドレナリンの筋注と生理食塩液の点滴静注