Adrenal Hormones Flashcards
1
Q
Which part of the adrenal gland secretes adrenocorticosteroids and adrenal androgens?
a. Medulla
b. Cortex
c. Inner layer
d. Middle layer
A
The correct answer is: b. Cortex
2
Q
Which part of the adrenal gland secretes epinephrine?
a. Cortex
b. Outer layer
c. Medulla
d. Middle layer
A
The correct answer is: c. Medulla
3
Q
The adrenal cortex is divided into how many zones?
a. Two
b. Three
c. Four
d. Five
A
The correct answer is: b. Three
4
Q
What is the source of steroids synthesized by the adrenal cortex?
a. Proteins
b. Lipids
c. Cholesterol
d. Carbohydrates
A
The correct answer is: c. Cholesterol
5
Q
Which layer of the adrenal cortex produces mineralocorticoids?
a. Outer layer
b. Middle layer
c. Inner layer
d. All layers
A
The correct answer is: a. Outer layer
6
Q
What is an example of a mineralocorticoid produced by the outer layer of the adrenal cortex?
a. Cortisol
b. Aldosterone
c. Epinephrine
d. Dehydroepiandrosterone
A
The correct answer is: b. Aldosterone
7
Q
Which layer of the adrenal cortex synthesizes glucocorticoids?
a. Outer layer
b. Middle layer
c. Inner layer
d. All layers
A
The correct answer is: b. Middle layer
8
Q
What is an example of a glucocorticoid synthesized by the middle layer of the adrenal cortex?
a. Cortisol
b. Aldosterone
c. Epinephrine
d. Dehydroepiandrosterone
A
The correct answer is: a. Cortisol
9
Q
Which layer of the adrenal cortex secretes adrenal androgens?
a. Outer layer
b. Middle layer
c. Inner layer
d. All layers
A
The correct answer is: c. Inner layer
10
Q
What is an example of an adrenal androgen secreted by the inner layer of the adrenal cortex?
a. Cortisol
b. Aldosterone
c. Epinephrine
d. Dehydroepiandrosterone
A
The correct answer is: d. Dehydroepiandrosterone
11
Q
Which zones of the adrenal cortex are controlled by pituitary ACTH?
a. Only the outer layer
b. The middle layer only
c. The inner layer only
d. The two inner zones and, to some extent, the outer zone
A
The correct answer is: d. The two inner zones and, to some extent, the outer zone
12
Q
What role do glucocorticoids play in the feedback mechanism of hormone secretion?
a. They promote ACTH and CRH secretion.
b. They inhibit ACTH and CRH secretion.
c. They have no effect on ACTH and CRH secretion.
d. They increase cholesterol synthesis.
A
The correct answer is: b. They inhibit ACTH and CRH secretion.
13
Q
Hormones of the adrenal cortex are used in all of the following EXCEPT:
a. Replacement therapy
b. Treatment of asthma
c. Treatment of severe allergic reactions
d. Treatment of bacterial infections
A
The correct answer is: d. Treatment of bacterial infections
14
Q
In what condition are hormones of the adrenal cortex used as replacement therapy?
a. Asthma
b. Rheumatoid arthritis
c. Adrenal insufficiency
d. Severe allergic reactions
A
The correct answer is: c. Adrenal insufficiency
15
Q
Which of the following inflammatory diseases can be treated with hormones of the adrenal cortex?
a. Diabetes
b. Asthma
c. Hypertension
d. Osteoporosis
A
The correct answer is: b. Asthma
16
Q
Which hormone is used in the treatment of severe allergic reactions?
a. Insulin
b. Glucocorticoids
c. Thyroxine
d. Growth hormone
A
The correct answer is: b. Glucocorticoids
17
Q
Hormones of the adrenal cortex are used in the treatment of some cancers.
a. True
b. False
A
The correct answer is: a. True
18
Q
Adrenocorticoids bind to specific intracellular cytoplasmic receptors in which type of tissues?
a. Muscle tissues
b. Target tissues
c. Bone tissues
d. Nerve tissues
A
The correct answer is: b. Target tissues
19
Q
The glucocorticoid receptor is widely distributed throughout the body, whereas the mineralocorticoid receptor is confined mainly to which type of organs?
a. Excretory organs
b. Digestive organs
c. Reproductive organs
d. Sensory organs
A
The correct answer is: a. Excretory organs
20
Q
Which organs are examples of those containing mineralocorticoid receptors?
a. Heart and lungs
b. Kidney and colon
c. Liver and pancreas
d. Brain and spinal cord
A
The correct answer is: b. Kidney and colon
21
Q
Which glands contain mineralocorticoid receptors?
a. Thyroid and parathyroid glands
b. Salivary and sweat glands
c. Adrenal and pituitary glands
d. Pineal and thymus glands
A
The correct answer is: b. Salivary and sweat glands
22
Q
Compared to mineralocorticoids, glucocorticoids have what spectrum of activity?
a. Narrower spectrum
b. Wider spectrum
c. Same spectrum
d. No spectrum
A
The correct answer is: b. Wider spectrum
23
Q
Which hormone is the principal glucocorticoid?
a. Aldosterone
b. Epinephrine
c. Cortisol
d. Dehydroepiandrosterone
A
The correct answer is: c. Cortisol
24
Q
Glucocorticoid production is diurnal with a peak occurring when?
a. Early in the morning
b. Late in the evening
c. Midday
d. Midnight
A
The correct answer is: a. Early in the morning
25
Glucocorticoid production follows an initial peak with a secondary, smaller peak at what time?
a. Late morning
b. Late afternoon
c. Early evening
d. Early morning
The correct answer is: b. Late afternoon
26
What factors influence glucocorticoid secretion?
a. Diet
b. Temperature and humidity
c. Stress
d. Sleep
The correct answer is: c. Stress
27
Glucocorticoids favor gluconeogenesis and stimulate the catabolism of which substance, except in the liver?
a. Carbohydrates
b. Fats
c. Proteins
d. Nucleic acids
The correct answer is: c. Proteins
28
Glucocorticoids stimulate which process to provide the building blocks for glucose synthesis?
a. Glycolysis
b. Lipolysis
c. Proteolysis
d. Glycogenesis
The correct answer is: b. Lipolysis
29
What condition is a result of the elevated blood glucose caused by glucocorticoids?
a. Hypoglycemia
b. Hyperlipidemia
c. Hyperglycemia
d. Hypolipidemia
The correct answer is: c. Hyperglycemia
30
How do glucocorticoids increase resistance to stress?
a. By lowering plasma glucose levels
b. By raising plasma glucose levels
c. By reducing plasma protein levels
d. By increasing plasma fat levels
The correct answer is: b. By raising plasma glucose levels
31
Glucocorticoids can cause a modest rise in blood pressure by enhancing what action?
a. Vasodilator action
b. Vasoabsorptive action
c. Vasoconstrictor action
d. Vasodepressor action
The correct answer is: c. Vasoconstrictor action
32
How do glucocorticoids alter blood cell levels in plasma?
a. Increase eosinophils, basophils, monocytes
b. Decrease eosinophils, basophils, monocytes
c. Increase lymphocytes
d. Decrease neutrophils
The correct answer is: b. Decrease eosinophils, basophils, monocytes
33
How do glucocorticoids affect lymphocytes?
a. Increase their production
b. Decrease their production
c. Redistribute them from circulation to lymphoid tissue
d. Eliminate them from the body
The correct answer is: c. Redistribute them from circulation to lymphoid tissue
34
Glucocorticoids increase the blood levels of which blood components?
a. Hemoglobin, erythrocytes, platelets, and neutrophils
b. Lymphocytes, monocytes, basophils, and eosinophils
c. Plasma proteins, serum, platelets, and lymphocytes
d. Hemoglobin, leukocytes, plasma, and serum
The correct answer is: a. Hemoglobin, erythrocytes, platelets, and neutrophils
35
Glucocorticoids have anti-inflammatory action by reducing what response?
a. Immune response
b. Metabolic response
c. Inflammatory response
d. Allergic response
The correct answer is: c. Inflammatory response
36
Glucocorticoids suppress what system in the body?
a. Respiratory system
b. Immune system
c. Digestive system
d. Circulatory system
The correct answer is: b. Immune system
37
What is a possible mechanism for the anti-inflammatory action of glucocorticoids?
a. Enhancing the function of macrophages
b. Inducing histamine release
c. Lowering and inhibiting peripheral lymphocytes and macrophages
d. Stimulating phospholipase A2
The correct answer is: c. Lowering and inhibiting peripheral lymphocytes and macrophages
38
Glucocorticoids indirectly inhibit which enzyme to reduce inflammation?
a. Phospholipase A2
b. COX-2
c. Lipase
d. Amylase
The correct answer is: a. Phospholipase A2
39
What effect do glucocorticoids have on histamine release?
a. Increase histamine release
b. Decrease histamine release
c. No effect on histamine release
d. Stimulate histamine production
The correct answer is: b. Decrease histamine release
40
Glucocorticoids affect other components of the endocrine system by feedback inhibition of which hormones?
a. ACTH and GH
b. TSH and GH
c. ACTH and TSH
d. TSH and FSH
The correct answer is: c. ACTH and TSH
41
In contrast, glucocorticoids increase the production of which hormone?
a. ACTH
b. GH
c. TSH
d. FSH
The correct answer is: b. GH
42
Adequate cortisol is essential for the normal function of which renal process?
a. Tubular reabsorption
b. Filtration rate
c. Secretion
d. Excretion
The correct answer is: b. Filtration rate
43
High doses of glucocorticoids stimulate the production of which gastric substances and may exacerbate ulcers?
a. Acid and bile
b. Bile and pepsin
c. Acid and pepsin
d. Pepsin and enzymes
The correct answer is: c. Acid and pepsin
44
How do glucocorticoids influence the central nervous system (CNS)?
a. They decrease metabolic rate
b. They influence mental status
c. They reduce brain activity
d. They increase synaptic transmission
The correct answer is: b. They influence mental status
45
Chronic glucocorticoid therapy can cause severe loss of which tissue?
a. Muscle
b. Bone
c. Adipose
d. Connective
The correct answer is: b. Bone
46
What are two potential adverse effects of chronic glucocorticoid therapy on muscles?
a. Myopathy and hypertrophy
b. Hypertrophy and weakness
c. Myopathy and weakness
d. Hypertrophy and spasm
The correct answer is: c. Myopathy and weakness
47
Mineralocorticoids help control the body's water volume and concentration of which substances?
a. Proteins
b. Carbohydrates
c. Electrolytes
d. Vitamins
The correct answer is: c. Electrolytes
48
Which electrolytes are especially regulated by mineralocorticoids?
a. Calcium and magnesium
b. Sodium and potassium
c. Chloride and phosphate
d. Iron and zinc
The correct answer is: b. Sodium and potassium
49
Aldosterone acts on which parts of the kidney to cause reabsorption of sodium, bicarbonate, and water?
a. Glomerulus and loop of Henle
b. Proximal tubule and distal tubule
c. Kidney tubules and collecting ducts
d. Renal cortex and renal medulla
The correct answer is: c. Kidney tubules and collecting ducts
50
What substances does aldosterone cause to be reabsorbed in the kidney?
a. Sodium, bicarbonate, and water
b. Potassium, chloride, and water
c. Urea, creatinine, and glucose
d. Phosphate, calcium, and magnesium
The correct answer is: a. Sodium, bicarbonate, and water
51
Conversely, aldosterone decreases the reabsorption of which electrolyte, which is then lost in the urine along with H+?
a. Sodium
b. Potassium
c. Calcium
d. Magnesium
The correct answer is: b. Potassium
52
Elevated aldosterone levels may cause which two conditions?
a. Hyperkalemia and acidosis
b. Hypernatremia and acidosis
c. Alkalosis and hypokalemia
d. Hypercalcemia and alkalosis
The correct answer is: c. Alkalosis and hypokalemia
53
The retention of sodium and water by aldosterone leads to an increase in which two parameters?
a. Blood volume and glucose level
b. Blood pressure and heart rate
c. Blood volume and blood pressure
d. Heart rate and glucose level
The correct answer is: c. Blood volume and blood pressure
54
Which of the following corticosteroids is classified as short-acting?
a. Prednisone
b. Hydrocortisone
c. Dexamethasone
d. Triamcinolone
Correct answer: b. Hydrocortisone
55
What is the duration of action for short-acting corticosteroids?
a. 1-12 hours
b. 12-36 hours
c. 36-55 hours
d. 55-72 hours
Correct answer: a. 1-12 hours
56
Which corticosteroid has both anti-inflammatory and salt-retaining effects of equal potency?
a. Prednisolone
b. Betamethasone
c. Cortisone
d. Methylprednisolone
Correct answer: c. Cortisone
57
Which intermediate-acting corticosteroid has an anti-inflammatory effect but no salt-retaining effect?
a. Prednisone
b. Methylprednisolone
c. Triamcinolone
d. Prednisolone
Correct answer: c. Triamcinolone
58
What is the duration of action for intermediate-acting corticosteroids?
a. 1-12 hours
b. 12-36 hours
c. 36-55 hours
d. 55-72 hours
Correct answer: b. 12-36 hours
59
Which of the following corticosteroids is classified as long-acting?
a. Betamethasone
b. Prednisone
c. Hydrocortisone
d. Triamcinolone
Correct answer: a. Betamethasone
60
What is the duration of action for long-acting corticosteroids?
a. 1-12 hours
b. 12-36 hours
c. 36-55 hours
d. 55-72 hours
Correct answer: c. 36-55 hours
61
Which long-acting corticosteroid has the highest anti-inflammatory effect?
a. Dexamethasone
b. Betamethasone
c. Methylprednisolone
d. Triamcinolone
Correct answer: b. Betamethasone
62
Which mineralocorticoid has the highest salt-retaining effect?
a. Fludrocortisone
b. Deoxycorticosterone
c. Cortisone
d. Hydrocortisone
Correct answer: a. Fludrocortisone
63
Which corticosteroid is primarily used for its mineralocorticoid effect rather than its anti-inflammatory effect?
a. Betamethasone
b. Dexamethasone
c. Fludrocortisone
d. Prednisolone
Correct answer: c. Fludrocortisone
64
Which semisynthetic derivative of glucocorticoids has been developed to vary in their anti-inflammatory potency?
a. Cortisone
b. Methylprednisolone
c. Deoxycorticosterone
d. Triamcinolone
Correct answer: b. Methylprednisolone
65
Which of the following corticosteroids shows a degree of sodium retention?
a. Betamethasone
b. Triamcinolone
c. Prednisolone
d. Dexamethasone
Correct answer: c. Prednisolone
66
Which mineralocorticoid has no anti-inflammatory effect but a significant salt-retaining effect?
a. Fludrocortisone
b. Deoxycorticosterone
c. Prednisone
d. Methylprednisolone
Correct answer: b. Deoxycorticosterone
67
What aspect do semisynthetic derivatives of glucocorticoids vary in?
a. Their half-life, target tissue, and duration of action.
b. Their bioavailability, route of administration, and effects on the immune the system.
c. Their anti-inflammatory potency, sodium retention, and duration of action.
d. Their lipid solubility, absorption, and excretion.
Correct answer: c. Their anti-inflammatory potency, sodium retention, and duration of action.
68
Which corticosteroid is given for replacement therapy in primary adrenocortical insufficiency (Addison's disease)?
a. Prednisolone
b. Dexamethasone
c. Hydrocortisone
d. Betamethasone
Correct answer: c. Hydrocortisone
69
In the treatment of Addison's disease, how is the daily dose of hydrocortisone typically divided?
a. Half in the morning and half in the evening
b. Two-thirds in the morning and one-third in the afternoon
c. One-third in the morning and two-thirds in the evening
d. Equal doses three times a day
Correct answer: b. Two-thirds in the morning and one-third in the afternoon
70
Which mineralocorticoid may be administered to raise the mineralocorticoid activity to normal levels in Addison's disease?
a. Prednisolone
b. Fludrocortisone
c. Dexamethasone
d. Hydrocortisone
Correct answer: b. Fludrocortisone
71
What is the primary synthetic mineralocorticoid used in the management of Addison's disease?
a. Cortisol
b. Fludrocortisone
c. Deoxycorticosterone
d. Triamcinolone
Correct answer: b. Fludrocortisone
72
What condition is treated with hydrocortisone to correct the deficiency in the adrenal cortex?
a. Cushing's syndrome
b. Addison's disease
c. Congenital adrenal hyperplasia
d. Rheumatoid arthritis
Correct answer: b. Addison's disease
73
In secondary or tertiary adrenocortical insufficiency, what stimulates the adrenal cortex to synthesize and release adrenal corticosteroids?
a. Hydrocortisone
b. Prednisolone
c. Corticotropin (ACTH)
d. Dexamethasone
Correct answer: c. Corticotropin (ACTH)
74
Which test is used for the diagnosis of Cushing's syndrome?
a. Cortisol suppression test
b. Dexamethasone suppression test
c. ACTH stimulation test
d. Fludrocortisone test
Correct answer: b. Dexamethasone suppression test
75
What is the primary therapeutic use of dexamethasone in endocrine disorders?
a. Replacement therapy for Addison's disease
b. Diagnosis of Cushing's syndrome
c. Treatment of rheumatoid arthritis
d. Management of asthma
Correct answer: b. Diagnosis of Cushing's syndrome
76
What hormone levels need to be normalized in congenital adrenal hyperplasia?
a. Cortisol and aldosterone
b. CRH and ACTH
c. Testosterone and estrogen
d. Insulin and glucagon
Correct answer: b. CRH and ACTH
77
Which therapy requires administration of corticosteroids to suppress the release of CRH and ACTH?
a. Treatment of Addison's disease
b. Replacement therapy for secondary adrenocortical insufficiency
c. Diagnosis of Cushing's syndrome
d. Replacement therapy for congenital adrenal hyperplasia
Correct answer: d. Replacement therapy for congenital adrenal hyperplasia
78
Glucocorticoids are used to reduce inflammation in which conditions?
a. Diabetes and hypertension
b. Asthma and allergic rhinitis
c. Rheumatoid arthritis and osteoarthritis
d. Addison's disease and Cushing's syndrome
Correct answer: c. Rheumatoid arthritis and osteoarthritis
79
What is a primary benefit of glucocorticoids in the treatment of allergies?
a. They reduce blood sugar levels
b. They enhance immune response
c. They reduce inflammatory symptoms
d. They increase energy levels
Correct answer: c. They reduce inflammatory symptoms
80
Which corticosteroids are used through inhalation for treating asthma and allergic reactions?
a. Hydrocortisone and prednisolone
b. Beclomethasone and triamcinolone
c. Dexamethasone and betamethasone
d. Fludrocortisone and deoxycorticosterone
Correct answer: b. Beclomethasone and triamcinolone
81
What syndrome is a problem in premature infants, requiring glucocorticoid treatment?
a. Addison's disease
b. Respiratory distress syndrome
c. Cushing's syndrome
d. Congenital adrenal hyperplasia
Correct answer: b. Respiratory distress syndrome
82
What is administered intramuscularly to enhance lung maturation in premature infants?
a. Hydrocortisone
b. Prednisolone
c. Betamethasone
d. Fludrocortisone
Correct answer: c. Betamethasone
83
Which glucocorticoid has no effect on the fetus during pregnancy?
a. Hydrocortisone
b. Prednisolone
c. Dexamethasone
d. Prednisone
Correct answer: d. Prednisone
84
What is the nature of prednisone as a drug?
a. Active compound
b. Prodrug
c. Mineralocorticoid
d. Anti-inflammatory
Correct answer: b. Prodrug
85
In what form does prednisone need to be converted to exert its effects?
a. Hydrocortisone
b. Cortisone
c. Prednisolone
d. Betamethasone
Correct answer: c. Prednisolone
86
Why does prednisone have no effect on the fetus in pregnancy?
a. It is metabolized in the maternal liver
b. It is not converted to the active compound in the fetal liver
c. It has low bioavailability
d. It has high protein binding
Correct answer: b. It is not converted to the active compound in the fetal liver
87
What happens when large doses of glucocorticoids are required for more than two weeks?
a. Increased metabolic rate
b. Enhanced immune response
c. Suppression of the hypothalamic-pituitary-adrenal (HPA) axis
d. Enhanced tissue regeneration
Correct answer: c. Suppression of the hypothalamic-pituitary-adrenal (HPA) axis
88
How can the adverse effect of HPA axis suppression be prevented?
a. Continuous daily administration
b. Intermittent high-dose therapy
c. Alternate-day administration
d. Reduced dosage administration
Correct answer: c. Alternate-day administration
89
What schedule allows the HPA axis to recover and function on non-hormone days?
a. Daily administration
b. Alternate-day administration
c. Twice daily administration
d. Weekly administration
Correct answer: b. Alternate-day administration
90
Why is withdrawal from corticosteroids a serious problem?
a. It causes allergic reactions
b. It leads to weight gain
c. It causes HPA suppression
d. It leads to muscle wasting
Correct answer: c. It causes HPA suppression
91
What condition can abrupt removal of corticosteroids cause?
a. Acute renal failure
b. Hyperglycemia
c. Acute adrenal insufficiency syndrome
d. Chronic fatigue syndrome
Correct answer: c. Acute adrenal insufficiency syndrome
92
How should the dose of corticosteroids be adjusted to avoid acute adrenal insufficiency?
a. Increased gradually
b. Reduced gradually
c. Maintained consistently
d. Administered intravenously
Correct answer: b. Reduced gradually
93
Osteoporosis due to long-term corticosteroid therapy is caused by:
a. The ability of glucocorticoids to suppress intestinal Ca2+ absorption
b. Inhibition of bone formation
c. Decrease sex hormone synthesis
d. Increase renal calcium excretion
Correct answer: b. Inhibition of bone formation
94
What supplementation is advised for patients on long-term corticosteroid therapy to prevent osteoporosis?
a. Iron and folic acid
b. Calcium and vitamin D
c. Magnesium and zinc
d. Vitamin A and vitamin C
Correct answer: b. Calcium and vitamin D
95
Which of the following is a common side effect of long-term corticosteroid therapy?
a. Hypotension
b. Cushing-like syndrome
c. Hyperthyroidism
d. Hypercalcemia
Correct answer: b. Cushing-like syndrome
96
Long-term corticosteroid therapy increases the frequency of:
a. Cataracts
b. Glaucoma
c. Retinal detachment
d. Macular degeneration
Correct answer: a. Cataracts
97
Which metabolic condition may develop due to long-term corticosteroid therapy and lead to diabetes mellitus?
a. Hypoglycemia
b. Hyperglycemia
c. Hyperlipidemia
d. Hypolipidemia
Correct answer: b. Hyperglycemia
98
What electrolyte imbalance is commonly seen with long-term corticosteroid use?
a. Hyperkalemia
b. Hypokalemia
c. Hypernatremia
d. Hyponatremia
Correct answer: b. Hypokalemia
99
Long-term corticosteroid therapy can lead to:
a. Increased growth in children
b. Decreased growth in children
c. Accelerated bone growth
d. Increased muscle mass
Correct answer: b. Decreased growth in children
100
A common side effect of long-term corticosteroid use is:
a. Decreased appetite
b. Increased appetite
c. Nausea
d. Vomiting
Correct answer: b. Increased appetite
101
Long-term corticosteroid therapy increases the risk of:
a. Hypertension
b. Infection
c. Thrombosis
d. Dehydration
Correct answer: b. Infection
102
Which of the following is a side effect of long-term corticosteroid therapy?
a. Peripheral neuropathy
b. Peripheral edema
c. Central cyanosis
d. Generalized urticaria
Correct answer: b. Peripheral edema
103
Co-administration of medications that induce or inhibit hepatic mixed-function oxidases may require adjustment of the glucocorticoid dose because they are:
a. Metabolized by liver P450s
b. Excreted by the kidneys
c. Absorbed in the intestines
d. Bound to plasma proteins
Correct answer: a. Metabolized by liver P450s
