This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Parathyroid and adrenal glands, Subject name: Surgery
During bilateral adrenalectomy, intra-operative dose of hydrocoisone should be given after: 
Select and explain. 
A. Opening the abdomen, B. Ligation of left adrenal vein, C. Ligation of right adrenal vein, D. Excision of both adrenal glands
D: Excision of both adrenal glands
Answer: D: Excision of both adrenal glands 
Explanation: Patients undergoing surgical treatment of endogenous hypercoisolism require glucocoicoid replacement. Steroids are not given pre-operatively because these patients are already hypercoisolemic. Instead hydrocoisone 100 mg IV is given after the removal of second hyperplastic adrenal gland.