Adrenal Disorders Flashcards
1
Q
Which of the following is NOT produced by the cortex? A. Androgen B. Glucocorticoids C. Catecholamines D. Mineralocorticoids
A
C. Catecholamines
2
Q
Aldosterone is produced in what part of the cortex? A. Zona glomerulosa B. Zona Fasciculata C. Zona Reticularis D. Medulla
A
A. Zona glomerulosa (produces mineralocorticoids)
3
Q
Cortisol is produced in what part of the cortex? A. Zona glomerulosa B. Zona Fasciculata C. Zona Reticularis D. Medulla
A
B. Zona Fasciculata (produces glucocorticoids)
4
Q
Androgens are produced in what part of the cortex? A. Zona glomerulosa B. Zona Fasciculata C. Zona Reticularis D. Medulla
A
C. Zona Reticularis (such as testosterone and estradiol)
5
Q
Which of the following is/are 21-carbon hormones? A. Mineralocorticoids B. Glucocorticoids C. Androgens D. A and B E. A and C
A
D. A and B
6
Q
Which of the following is/are 19-carbon hormones? A. Mineralocorticoids B. Glucocorticoids C. Androgens D. A and B E. A and C
A
C. Androgens
7
Q
The first step in hormone synthesis in the adrenal gland involves _____.
A
Cholesterol
8
Q
The second step in hormone synthesis in the adrenal gland involves _____.
A
Progenolone
9
Q
What causes the release of renin in the RAA system?
A
Juxtaglomerular cells
10
Q
What is the purpose of renin release in the RAA system?
A
Conversion of angiotensinogen into angiotensin I
11
Q
Angiotensin II in the RAA system causes the activation of _____.
A
Angiotensin II receptor type 1 (AT1 receptor)
12
Q
AT1 receptor in the RAA system causes the release of ________.
A
Aldosterone
13
Q
True or False: The release of aldosterone causes the renal retention of sodium and potassium.
A
FALSE: It only causes the retention of sodium, and increases potassium secretion.
14
Q
What triggers the RAA system to produce aldosterone?
A
Hypotension, Hypovolemia (low sodium, low fluids)
15
Q
Androgen release is increased during \_\_\_\_. A. Puberty B. Aging C. Fasting states D. Two of the above E. All of the above
A
A. Puberty
16
Q
Androgen release is decreased during \_\_\_\_. A. Puberty B. Aging C. Fasting states D. Two of the above E. All of the above
A
D. Two of the above (aging and fasting states)
17
Q
Increase in androgen release causes ___ in women.
A
Hirsutism
18
Q
Name some signs/symptoms of Cushing’s Syndrome?
A
Weight gain (Most common) Facial rounding Buffalo hump Bruising Purple striae Long term effects: - Osteoporosis - Depression - Hypertension/Hypotension
19
Q
In treatment of Cushing's Syndrome, which of the following must be used with Metyrapone because it has higher relapse rates? A. Ketoconazole B. Aminoglutethimide C. Mitotane D. Cyproheptadine E. Mifepristone
A
B. Aminoglutethimide
20
Q
In treatment of Cushing's Syndrome, which of the following is not often used because of its severe adverse effects, such as ataxia and severe sedation, due to its broad mechanism of action (inhibits conversion of cholesterol to progenolone)? A. Ketoconazole B. Aminoglutethimide C. Mitotane D. Cyproheptadine E. Mifepristone F. Metyrapone
A
B. Aminoglutethimide
21
Q
In treatment of Cushing's Syndrome, which of the following requires monitoring of LFTs due to reversible LFT elevations? A. Ketoconazole B. Aminoglutethimide C. Mitotane D. Cyproheptadine E. Mifepristone F. Metyrapone
A
A. Ketoconazole
22
Q
In treatment of Cushing's Syndrome, which of the following is an adrenolytic agent? A. Ketoconazole B. Aminoglutethimide C. Mitotane D. Cyproheptadine E. Mifepristone F. Metyrapone
A
C. Mitotane
23
Q
In treatment of Cushing's Syndrome, which of the following is a neuromodulator? A. Ketoconazole B. Aminoglutethimide C. Mitotane D. Cyproheptadine E. Mifepristone F. Metyrapone
A
D. Cyproheptadine
24
Q
In treatment of Cushing's Syndrome, which of the following is a glucocorticoid-receptor blocker? A. Ketoconazole B. Aminoglutethimide C. Mitotane D. Cyproheptadine E. Mifepristone F. Metyrapone
A
E. Mifepristone
25
```
In treatment of Cushing's Syndrome, which of the following is an abortive agent?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
E. Mifepristone
26
```
In treatment of Cushing's Syndrome, which of the following is not recommended in women who want to get pregnant in the next 5 years due to the fact that it is stored in adipose tissue for years after discontinuation?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
C. Mitotane
27
```
In treatment of Cushing's Syndrome, which of the following has anti-androgenic effects?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
A. Ketoconazole
28
```
In treatment of Cushing's Syndrome, which of the following should not be used in women due to its increase in androgenic effects?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
F. Metyrapone
29
```
In treatment of Cushing's Syndrome, which of the following causes increase in anti-cholinergic effects, weight gain, and/or sedation due to its mechanism as a histamine and serotonin antagonist?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
D. Cyproheptadine
30
```
In treatment of Cushing's Syndrome, which of the following takes weeks to months to kick in due to its mechanism as an adrenolytic agent?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
C. Mitotane
31
```
In treatment of Cushing's Syndrome, which of the following takes weeks to months to kick in (multiple answers possible)?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
A. Ketoconazole
| C. Mitotane
32
```
In treatment of Cushing's Syndrome, which of the following should not be used in men due to its anti-androgenic effects that can lead to hypogonadism?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
A. Ketoconazole
33
```
In treatment of Cushing's Syndrome, which of the following requires monitoring of blood pressure as well as electrolytes?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
F. Metyrapone
34
```
In treatment of Cushing's Syndrome, which of the following may require potassium supplementation due to its hypokalemic effects?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
E. Mifepristone
35
```
In treatment of Cushing's Syndrome, which of the following require serum potassium monitoring (multiple answers)?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
C. Mitotane
| E. Mifepristone
36
```
In treatment of Cushing's Syndrome, which of the following requires pregnancy testing in women of child-bearing age before initiation?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
E. Mifepristone
37
```
In treatment of Cushing's Syndrome, which of the following can cause neurological disturbances in about 40% of patients, which is why patients who are starting this medication are often hospitalized and monitored?
A. Ketoconazole
B. Aminoglutethimide
C. Mitotane
D. Cyproheptadine
E. Mifepristone
F. Metyrapone
```
C. Mitotane
38
A disease that is an example of primary adrenal insufficiency is ____.
Addison's Disease
39
True or False: Autoimmune related disorders, such as T1DM, lupus, and MS, can contribute to development of primary adrenal insufficiency.
True
40
A risk factor for adrenal insufficiency is patients who are on medications that inhibit cortisol production. These would include CYP450 inducers, such as _____, ____, ___, and _____.
Ketoconazole
Phenytoin
Rifampin
Phenobarbital
41
Adrenal insufficiency is test for using which of the following tests?
A. Low-dose dexamethasone suppression test
B. Short cosyntropin stimulation test
C. Prenatal testing
D. Mineralocorticoid suppression test
B. Short cosyntropin stimulation test
