Adrenal Hormones Flashcards
The adrenal gland consists of the cortex and the medulla. The cortex secretes:
a. Epinephrine
b. Adrenocorticosteroids and adrenal androgens
c. Insulin
d. Glucagon
b. Adrenocorticosteroids and adrenal androgens
The adrenal medulla primarily secretes:
a. Cortisol
b. Aldosterone
c. Epinephrine
d. Adrenal androgens
c. Epinephrine
The adrenal cortex is divided into three zones. The outer layer produces:
a. Glucocorticoids
b. Epinephrine
c. Adrenal androgens
d. Mineralocorticoids
d. Mineralocorticoids
The middle layer of the adrenal cortex synthesizes:
a. Mineralocorticoids
b. Glucocorticoids
c. Adrenal androgens
d. Epinephrine
b. Glucocorticoids
The inner layer of the adrenal cortex secretes:
a. Glucocorticoids
b. Mineralocorticoids
c. Adrenal androgens
d. Epinephrine
c. Adrenal androgens
An example of a mineralocorticoid produced by the adrenal cortex is:
a. Cortisol
b. Epinephrine
c. Aldosterone
d. Dehydroepiandrosterone
c. Aldosterone
The middle layer of the adrenal cortex produces glucocorticoids such as:
a. Cortisol
b. Aldosterone
c. Epinephrine
d. Dehydroepiandrosterone
a. Cortisol
Adrenal androgens secreted by the inner layer of the adrenal cortex include:
a. Cortisol
b. Aldosterone
c. Epinephrine
d. Dehydroepiandrosterone
d. Dehydroepiandrosterone
The adrenal cortex synthesizes various steroids from:
a. Proteins
b. Carbohydrates
c. Cholesterol
d. Nucleic acids
c. Cholesterol
Secretion by the two inner zones and, to some extent, the outer zone of the adrenal cortex is controlled by:
a. Thyroid-stimulating hormone (TSH)
b. Luteinizing hormone (LH)
c. Adrenocorticotropic hormone (ACTH)
d. Growth hormone (GH)
c. Adrenocorticotropic hormone (ACTH)
Glucocorticoids serve as feedback inhibitors of:
a. ACTH and CRH secretion
b. TSH and LH secretion
c. GH and prolactin secretion
d. FSH and LH secretion
a. ACTH and CRH secretion
Hormones of the adrenal cortex are used in all of the following EXCEPT:
a. Replacement therapy
b. Treatment and management of asthma and other inflammatory diseases
c. Treatment of severe allergic reactions
d. Treatment of diabetes mellitus
d. Treatment of diabetes mellitus
Which of the following is a use of adrenal cortex hormones in replacement therapy?
a. Addison’s disease treatment
b. Diabetes management
c. Hypertension control
d. Hyperthyroidism treatment
a. Addison’s disease treatment
Adrenal cortex hormones are used in the treatment of inflammatory diseases such as:
a. Diabetes
b. Hypertension
c. Rheumatoid arthritis
d. Hyperthyroidism
c. Rheumatoid arthritis
In the treatment of severe allergic reactions, adrenal cortex hormones are used for their:
a. Hyperglycemic effect
b. Anti-inflammatory effect
c. Antihypertensive effect
d. Diuretic effect
b. Anti-inflammatory effect
The secretion of ACTH is stimulated by:
a. Aldosterone
b. Corticotropin-releasing hormone (CRH)
c. Epinephrine
d. Norepinephrine
b. Corticotropin-releasing hormone (CRH)
The adrenocorticoids bind to specific intracellular cytoplasmic receptors in:
a. The bloodstream
b. The cell membrane
c. Target tissues
d. The extracellular matrix
c. Target tissues
The glucocorticoid receptor is:
a. Widely distributed throughout the body
b. Confined mainly to excretory organs
c. Found only in the brain
d. Limited to the liver and kidneys
a. Widely distributed throughout the body
The mineralocorticoid receptor is primarily found in:
a. The brain and spinal cord
b. The heart and lungs
c. Excretory organs such as the kidney, colon, salivary, and sweat glands
d. The pancreas and thyroid
c. Excretory organs such as the kidney, colon, salivary, and sweat glands
Compared to the mineralocorticoid receptor, the glucocorticoid receptor:
a. Has a narrower spectrum of activity
b. Has a wider spectrum of activity
c. Is more specific to kidney function
d. Is less widely distributed
b. Has a wider spectrum of activity
Mineralocorticoid receptors are mostly involved in the regulation of:
a. Immune response
b. Metabolic rate
c. Excretory functions
d. Nervous system functions
c. Excretory functions
Cortisol is the principal:
a. Mineralocorticoid
b. Sex hormone
c. Glucocorticoid
d. Catecholamine
c. Glucocorticoid
Glucocorticoid production is:
a. Continuous throughout the day
b. Diurnal, with a peak early in the morning followed by a decline and then a secondary, smaller peak in the late afternoon
c. Highest during the night
d. Irregular and unpredictable
b. Diurnal, with a peak early in the morning followed by a decline and then a secondary, smaller peak in the late afternoon
Factors such as stress influence:
a. Blood pressure
b. Heart rate
c. Glucocorticoid secretion
d. Body temperature
c. Glucocorticoid secretion
The effects of cortisol include:
a. Increasing insulin sensitivity
b. Decreasing gluconeogenesis
c. Inhibiting protein catabolism
d. Favoring gluconeogenesis and stimulating protein catabolism (except in the liver) and lipolysis
d. Favoring gluconeogenesis and stimulating protein catabolism (except in the liver) and lipolysis
One of the outcomes of glucocorticoid action is:
a. Hypoglycemia
b. Hyperglycemia
c. Hyperkalemia
d. Hypocalcemia
c. Hyperkalemia
How do glucocorticoids increase resistance to stress?
a. By decreasing blood pressure
b. By increasing heart rate
c. By raising plasma glucose levels
d. By lowering plasma glucose levels
c. By raising plasma glucose levels
What effect do glucocorticoids have on blood pressure?
a. They cause a significant drop in blood pressure
b. They cause a modest rise in blood pressure
c. They have no effect on blood pressure
d. They cause a significant rise in blood pressure
b. They cause a modest rise in blood pressure
How do glucocorticoids alter blood cell levels in plasma?
a. By increasing eosinophils and basophils
b. By decreasing eosinophils, basophils, and monocytes
c. By increasing lymphocytes in circulation
d. By decreasing hemoglobin and erythrocytes
b. By decreasing eosinophils, basophils, and monocytes
How do glucocorticoids affect lymphocytes?
a. Increase lymphocytes in the bloodstream
b. Redistribute lymphocytes from the circulation to lymphoid tissue
c. Decrease lymphocytes in the lymphoid tissue
d. Have no effect on lymphocytes
b. Redistribute lymphocytes from the circulation to lymphoid tissue
Which of the following is not an effect of glucocorticoids on blood cells?
a. Decrease eosinophils
b. Decrease basophils
c. Increase monocytes
d. Increase neutrophils
c. Increase monocytes
Glucocorticoids have anti-inflammatory action by:
a. Increasing the inflammatory response
b. Reducing the inflammatory response
c. Enhancing immunity
d. Increasing histamine release
b. Reducing the inflammatory response
Glucocorticoids suppress immunity by:
a. Increasing peripheral lymphocytes
b. Lowering and inhibiting peripheral lymphocytes and macrophages
c. Enhancing COX-2 synthesis
d. Increasing phospholipase A2 activity
b. Lowering and inhibiting peripheral lymphocytes and macrophages
Which of the following is a mechanism of glucocorticoids’ anti-inflammatory action?
a. Indirect inhibition of phospholipase A2
b. Increasing COX-2 synthesis
c. Enhancing histamine release
d. Stimulating peripheral lymphocytes
a. Indirect inhibition of phospholipase A2
Glucocorticoids’ anti-inflammatory action can be due to:
a. Increasing peripheral lymphocytes
b. Enhancing macrophage activity
c. Indirect inhibition of phospholipase A2, reduced COX-2 synthesis in inflammatory cells
d. Increasing histamine release
c. Indirect inhibition of phospholipase A2, reduced COX-2 synthesis in inflammatory cells
Which of the following is NOT a mechanism by which glucocorticoids exert their anti-inflammatory effects?
a. Lowering peripheral lymphocytes
b. Inhibiting macrophages
c. Increasing histamine release
d. Reducing COX-2 synthesis
c. Increasing histamine release
Feedback inhibition of ACTH and TSH production by glucocorticoids results in:
a. Increased production of GH
b. Decreased production of insulin
c. Decreased production of ACTH and TSH
d. Increased production of cortisol
c. Decreased production of ACTH and TSH
Glucocorticoids affect other components of the endocrine system by:
a. Increasing ACTH production
b. Inhibiting ACTH and TSH production
c. Reducing GH production
d. Enhancing insulin secretion
b. Inhibiting ACTH and TSH production
Adequate cortisol is essential for:
a. Normal liver function
b. Normal adrenal function
c. Normal renal GF
d. Normal thyroid function
c. Normal renal GF
High doses of glucocorticoids can:
a. Decrease gastric acid production
b. Increase insulin sensitivity
c. Stimulate gastric acid and pepsin production
d. Decrease pepsin production
c. Stimulate gastric acid and pepsin production
On the CNS, glucocorticoids:
a. Do not influence mental status
b. Influence mental status
c. Only affect physical coordination
d. Have no effect on cognitive functions
b. Influence mental status
Chronic glucocorticoid therapy can cause:
a. Severe bone loss, myopathy, and weakness
b. Increased bone density
c. Enhanced muscle strength
d. Reduced risk of fractures
a. Severe bone loss, myopathy, and weakness
In contrast to the feedback inhibition by glucocorticoids, GH production is:
a. Decreased
b. Increased
c. Unaffected
d. Suppressed
b. Increased
Mineralocorticoids help to control the body’s:
a. Glucose levels
b. Body temperature
c. Water volume and concentration of electrolytes
d. Heart rate
c. Water volume and concentration of electrolytes
Aldosterone acts on:
a. Liver cells
b. Heart muscle
c. Kidney tubules and collecting ducts
d. Brain cells
c. Kidney tubules and collecting ducts
Aldosterone causes a reabsorption of:
a. Calcium and magnesium
b. Glucose and fructose
c. Sodium, bicarbonate, and water
d. Proteins and lipids
c. Sodium, bicarbonate, and water
Conversely, aldosterone decreases reabsorption of:
a. Sodium
b. Potassium
c. Calcium
d. Magnesium
b. Potassium
Elevated aldosterone levels may cause:
a. Hypercalcemia and hyperglycemia
b. Alkalosis and hypokalemia
c. Acidosis and hypernatremia
d. Hypoglycemia and hyperlipidemia
b. Alkalosis and hypokalemia
Retention of sodium and water leads to:
a. Decreased heart rate
b. Increased respiratory rate
c. Decreased blood volume
d. Increased blood volume and blood pressure
d. Increased blood volume and blood pressure
Which of the following corticosteroids is classified as short-acting?
a. Betamethasone
b. Prednisolone
c. Hydrocortisone
d. Fludrocortisone
c. Hydrocortisone
Which of the following is an intermediate-acting glucocorticoid?
a. Dexamethasone
b. Hydrocortisone
c. Prednisone
d. Deoxycorticosterone
c. Prednisone
Which corticosteroid has a duration of action of 36-55 hours?
a. Hydrocortisone
b. Dexamethasone
c. Prednisolone
d. Fludrocortisone
b. Dexamethasone
Semisynthetic derivatives of glucocorticoids vary in:
a. Their anti-inflammatory potency
b. Degree to which they cause sodium retention
c. Duration of action
d. All of the above
d. All of the above
Hydrocortisone (cortisol) is given to correct the deficiency in:
a. Cushing’s syndrome
b. Graves’ disease
c. Addison’s disease
d. Acromegaly
c. Addison’s disease
The dosage of hydrocortisone for treating primary adrenocortical insufficiency is divided so that:
a. The entire dose is given in the morning
b. Two-thirds of the daily dose is given in the morning and one-third in the afternoon
c. The entire dose is given in the evening
d. Half of the dose is given in the morning and half in the evening
b. Two-thirds of the daily dose is given in the morning and one-third in the afternoon
Administration of fludrocortisone is necessary to:
a. Increase glucocorticoid activity
b. Lower cortisol levels
c. Raise the mineralocorticoid activity to normal levels
d. Decrease aldosterone levels
c. Raise the mineralocorticoid activity to normal levels
Which of the following is a potent synthetic mineralocorticoid with some glucocorticoid activity?
a. Hydrocortisone
b. Prednisone
c. Fludrocortisone
d. Dexamethasone
c. Fludrocortisone
Replacement therapy for secondary or tertiary adrenocortical insufficiency involves:
a. Increasing thyroid hormone levels
b. Administering mineralocorticoids
c. Administering corticotropin (ACTH)
d. Using anabolic steroids
c. Administering corticotropin (ACTH)
The adrenal cortex responds to corticotropin (ACTH) administration by:
a. Reducing glucose levels
b. Lowering blood pressure
c. Synthesizing and releasing adrenal corticosteroids
d. Increasing insulin sensitivity
c. Synthesizing and releasing adrenal corticosteroids
Hydrocortisone is used for:
a. Increasing adrenaline production
b. Lowering cholesterol levels
c. Treating adrenal corticosteroid deficiencies
d. Enhancing muscle growth
c. Treating adrenal corticosteroid deficiencies
The dexamethasone suppression test is used for:
a. Diagnosing the cause of Cushing’s syndrome
b. Treating Addison’s disease
c. Increasing cortisol production
d. Reducing inflammation
a. Diagnosing the cause of Cushing’s syndrome
For diagnosing Cushing’s syndrome, which of the following is used?
a. Hydrocortisone
b. Dexamethasone
c. Fludrocortisone
d. Prednisone
b. Dexamethasone
Replacement therapy for congenital adrenal hyperplasia requires:
a. Administration of insulin
b. Increasing the release of CRH and ACTH
c. Administration of corticosteroids to normalize hormone levels
d. Use of anabolic steroids
c. Administration of corticosteroids to normalize hormone levels
The administration of corticosteroids in congenital adrenal hyperplasia works by:
a. Suppressing the release of CRH and ACTH
b. Increasing the production of adrenal androgens
c. Stimulating thyroid hormone production
d. Enhancing the immune response
a. Suppressing the release of CRH and ACTH
Glucocorticoids are used to reduce:
a. Blood pressure
b. Rheumatoid and osteoarthritic inflammations
c. Heart rate
d. Blood glucose levels
b. Rheumatoid and osteoarthritic inflammations
In addition to reducing rheumatoid and osteoarthritic inflammations, glucocorticoids also help in:
a. Enhancing muscle growth
b. Reducing inflammatory conditions of the skin
c. Increasing metabolism
d. Lowering cholesterol levels
b. Reducing inflammatory conditions of the skin
Glucocorticoids are beneficial in the treatment of:
a. Hypertension
b. Infections
c. Allergies
d. Diabetes
c. Allergies
Beclomethasone and triamcinolone are administered:
a. Orally
b. Through inhalation
c. Intravenously
d. Topically
b. Through inhalation
Acceleration of lung maturation in premature infants can be achieved with:
a. Hydrocortisone
b. Betamethasone or dexamethasone
c. Prednisolone
d. Fludrocortisone
b. Betamethasone or dexamethasone
The administration route for enhancing lung maturation in premature infants is:
a. Oral
b. Intramuscular
c. Intravenous
d. Inhalation
b. Intramuscular
The only glucocorticoid that has no effect on the fetus in pregnancy is:
a. Prednisolone
b. Dexamethasone
c. Hydrocortisone
d. Prednisone
d. Prednisone
Glucocorticoids are used in the treatment of asthma, allergic rhinitis, and:
a. Allergic reactions
b. Infections
c. Hypertension
d. Diabetes
a. Allergic reactions
Prednisone is a prodrug that is not converted to the active compound, prednisolone, in the:
a. Adult liver
b. Placenta
c. Fetal liver
d. Kidneys
c. Fetal liver
When large doses of glucocorticoids are required over an extended period of time (more than 2 weeks), suppression of the:
a. Hypothalamic-thyroid axis occurs
b. Pituitary-gonadal axis occurs
c. Hypothalamic-pituitary-adrenal (HPA) axis occurs
d. Hypothalamic-pituitary-thyroid (HPT)
c. Hypothalamic-pituitary-adrenal (HPA) axis occurs
To prevent HPA axis suppression, a regimen of alternate-day administration of adrenocortical steroids:
a. Increases the risk of side effects
b. May be useful
c. Should be avoided
d. Has no impact
b. May be useful
Withdrawal from corticosteroids can be a serious problem because:
a. It causes hypertension
b. The patient may have experienced HPA suppression
c. It leads to increased cortisol levels
d. It results in hyperglycemia
b. The patient may have experienced HPA suppression
Abrupt removal of corticosteroids can cause:
a. Hypothyroidism
b. Cushing’s syndrome
c. Acute adrenal insufficiency syndrome
d. Addison’s disease
c. Acute adrenal insufficiency syndrome
To avoid acute adrenal insufficiency syndrome, corticosteroid doses must be:
a. Increased gradually
b. Stopped immediately
c. Tapered gradually
d. Maintained at the same level
c. Tapered gradually
Osteoporosis due to long-term corticosteroid therapy is primarily because:
a. The ability of glucocorticoids to suppress intestinal Ca2+ absorption
b. Inhibit bone formation
c. Decrease sex hormone synthesis
d. Increase bone resorption
b. Inhibit bone formation
Alternate-day dosing of corticosteroids:
a. Prevents osteoporosis
b. Does not prevent osteoporosis
c. Increases the risk of hyperglycemia
d. Reduces the frequency of infections
b. Does not prevent osteoporosis
Patients on long-term corticosteroid therapy are advised to take:
a. Iron supplements
b. Calcium and vitamin D supplements
c. Vitamin B12 supplements
d. Potassium supplements
b. Calcium and vitamin D supplements
Which of the following is a common side effect of long-term corticosteroid therapy?
a. Cushing-like syndrome
b. Hypoglycemia
c. Hyperkalemia
d. Increased frequency of fractures
a. Cushing-like syndrome
Coadministration of medications that induce or inhibit hepatic mixed-function oxidases may require adjustment of the glucocorticoid dose because:
a. They are metabolized by the kidney
b. They are metabolized by liver P450s
c. They increase glucocorticoid absorption
d. They decrease glucocorticoid efficacy
b. They are metabolized by liver P450s
