Adrenal Drugs

Question 1

What enzyme in the kidney and placenta converts cortisol to cortisone?

Answer 1

11beta-hydroxysteroid dehydrogenase 2

Question 2

Glucocorticoid synthesis inhibitor that inhibits 11 beta hydroxylase?

Answer 2

metyrapone

Question 3

What is the first-line treatment of pheochromocytoma?

Answer 3

surgery

Question 4

Cortisol is part of what adrenal corticosteroid class?

Answer 4

Glucocorticoids

Question 5

What enzyme in the liver converts cortisone to cortisol?

Answer 5

11beta-hydroxysteroid dehydrogenase 1

Question 6

Do glucocorticoids increase or decrease blood glucose?

Answer 6

increase

Question 7

What is the first treatment in pre-operative alpha-adrenergic receptor blockade for PCC?

Answer 7

Irreversible α1-α2 receptor antagonist (Phenoxybenzamine)

Question 8

What additional treatment can be used if alpha- and beta- blockade are inadequate in the treatment of hypertension for PCC?

Answer 8

CCB (nifedipine)

Question 9

Where are epinephrine/norepinephrine produced in the adrenal gland?

Answer 9

adrenal medulla

Question 10

Aldosterone is part of what adrenal corticosteroid class?

Answer 10

Mineralocorticoid

Question 11

What treatment follows alpha block in the pre-operative alpha-adrenergic receptor blockade for PCC?

Answer 11

Beta-blockade (metoprolol)

Question 12

What must precede surgery for treatment of PCC to avoid a hypertensive crisis?

Answer 12

pre-operative alpha-adrenergic receptor blockade

Question 13

competitive inhibitor of catecholamine synthesis

Answer 13

Metyrosine

Question 14

Where are mineralocotricoids produced in the adrenal gland?

Answer 14

zona glomerulosa of the adrenal cortex

Question 15

Where are androgens produced in the adrenal gland?

Answer 15

zona reticularis of the adrenal cortex

Question 16

Arrange these adrenocorticosteroids from the most potent to the least potent anti-inflammatory agent:
Cortisol, prednisone, triamcinolone, dexamethasone, aldosterone, fludrocortisone

Answer 16

dexamethasone > fludrocortisone > triamcinolone > prednisone > cortisol > aldosterone

Question 17

Glucocorticoid synthesis inhibitor that inhibits 20, 22 desmolase (conversion of cholesterol to pregnenolone)?

Answer 17

ketoconazole and aminoglutethimide

Question 18

What is the rate limiting step of cholesterol hormone synthesis?

Answer 18

20, 22 desmolase (conversion of cholesterol to pregnenolone)

Question 19

DHEA is part of what adrenal corticosteroid class?

Answer 19

Androgen

Question 20

Do mineralocorticoids increase or decrease reabsorption of potassium and hydrogen at the kidney?

Answer 20

decrease

Question 21

Do glucocorticoids increase or decrease protein synthesis?

Answer 21

decrease

Question 22

Do glucocorticoids increase or decrease lipolysis?

Answer 22

increase

Question 23

Arrange these adrenocorticosteroids from the most potent to the least potent salt-retaining agent:
Cortisol, prednisone, triamcinolone, dexamethasone, aldosterone, fludrocortisone

Answer 23

aldosterone > fludrocortisone > cortisol > prednisone > triamcinolone = dexamethasone

Question 24

Where are glucocorticoids produced in the adrenal gland?

Answer 24

zona fasiculata of the adrenal cortex

Question 25

What other treatment should be considered in a patient with Addison’s disease besides cortisol replacement?

Answer 25

fludrocortisone (maybe DHEA)

Question 26

Do mineralocorticoids increase or decrease reabsorption of sodium at the kidney?

Answer 26

increase

Question 27

What would happen if you blocked Beta2 receptors prior to alpha receptors in the pre-operative alpha-adrenergic receptor blockade for PCC?

Answer 27

sever hypertension/hypertensive crisis

Question 28

Glucocorticoid synthesis inhibitor that inhibits cholesterol oxidase (mitochondrial toxin)?

Answer 28

mitotane

Question 29

Glucocorticoid receptor antagonist

Answer 29

Mifepristone

Question 30

Glucocorticoid synthesis inhibitor that inhibits 3 beta-hydroxysteroid dehydrogenase?

Answer 30

trilostane