Pharmacology- pain mangement 2 ; corticosteroids

Question 1

what is is targeted by corticosteroids?

a. muscles
b. HPA axis
c. heart

Answer 1

b. HPA axis

Question 2

what is the HPA axis made up of?

Answer 2

Hypothalamic pituitary adrenal glands

Question 3

what hormone acts on the pituitary gland in the HPA axis?

a. CRH
b. ACTH
c. Adrenaline
d. cortisol

Answer 3

a.CRH

Question 4

where ACTH hormone act?

a. hypothalamus
b. pituitary gland
c. adrenal glands

Answer 4

c.adrenal glands

Question 5

what triggers the hypothalamus to release CRH?

a. external triggers
b. stress and circadian rhythms
c. water levels
d. sodium concentration in blood

Answer 5

b.stress and circadian rhythms

Question 6

from top to bottom what is the correct order of the 3 distinct histological zones of adrenal cortex?

a. glomerulosa, fasciculata, reticularis
b. reticularis, fasciculata, glomerulosa
c. fasiculata, glomerulosa, reticularis

Answer 6

a.glomerulosa, fasciculata, reticularis

Question 7

where are catecholamines produced?

a. inner medulla of adrenal cortex
b. reticularis
c. fasciculata
d. glomerulosa

Answer 7

a.inner medulla of adrenal cortex

Question 8

where is the the glucocorticoid receptor expressed?

a. epithelial cells
b. kidney
c. widely
d. colon

Answer 8

c.widely

Question 9

where is the mineralocorticoid receptor expressed?

a. epithelial cells, kidney, colon,bladder
b. endothelial cells, kidney, colon, bladder
c. epithelial cells, kidney, colon liver
d. endothelial cells, kidney, colon , liver

Answer 9

a.epithelial cells, kidney, colon, bladder

Question 10

what is the main use of glucocorticoids?

a. anti inflammatory and pain relief
b. regulate electrolyte balance
c. regulate emotions
d. increase muscle

Answer 10

a.anti inflammatory and pain relief

Question 11

what type of corticosteroid regulates electrolyte balance in the kidney

a. mineralcorticoids
b. glucocorticoids

Answer 11

a. mineralocorticoids

Question 12

what are the structures of corticosteroids based on?

a. phosphate
b. cholesterol
c. glucose
d. beta lactam

Answer 12

b.cholesterol

Question 13

hydrocortisone, prednisolone, methylprednisolone, beclomethasone and dexamethosome are examples of what type of corticosteroid?

a. glucocorticoids
b. mineralocorticoids

Answer 13

a.glucocorticoids

Question 14

which one of these glucocorticoids is found in brown inhalers for asthma?

a. dexamethosone
b. beclomethasone
c. betamethosone
d. prednisolone

Answer 14

b.beclomethasone

Question 15

which glucocorticoid is the most potent?

a. prednisilone
b. beclomethasone
c. deflazacort
d. dexamethosone

Answer 15

d.dexamethosone

Question 16

where is the glucocorticoids receptor found?

a. in the cytoplasm
b. in the plasma membrane

Answer 16

a. in the cytoplasm

Question 17

what type of corticosteroid has an anti insulin effect?

a. mineralocorticoids
b. glucocorticoids

Answer 17

b.glucocorticoids

Question 18

aldosterone and fludrocortisone are examples of what type of corticosteroid?

a. mineralocorticoids
b. glucocorticoids

Answer 18

a.mineralocorticoids

Question 19

in congestive heart failure spironolactone is used as a K+ sparing agent. what type of corticosteroid is this?

a. glucocorticoid
b. mineralocorticoid

Answer 19

b.mineralocorticoid

Question 20

Conn syndrome is caused by an excess secretion of what corticosteroid?

a. glucocorticoid
b. mineralocorticoid

Answer 20

b, mineralocorticoid

Question 21

Whta is the mechanism of action of glucocorticoid?

Answer 21

bind to chaperone protein
enter cell through plasma membrane 
bind to transcription factor receptor
change in conformation exposes DNA binding domain 
binds to DNA 
mRNA and protein expressed

Question 22

how does the glucocorticoid receptor identify its target genes?

Answer 22

GC receptor binds to specific hormone response elements on target genes

Question 23

key actions of glucocorticoids

a. anti inflammatory, immunosuppressive, metabolic
b. anti inflammatory, metabolic
c. antiinflmatory, electrolyte balance

Answer 23

a. anti inflam, immunosupressive, metabolic

Question 24

what metabolism is affected by glucocorticoids?

a. lipid and protein metabolism
b. carbohydrate and protein metabolism
c. carbohydrate and lipid metabolism
d. glucose metabolism

Answer 24

b.carbohydrate and protein metabolism

Question 25

effect of glucocorticoids on the liver? a. gluconeogenesis and decrease glucose uptake b. glycogenolysis and reduce glucose uptake c. glycolysis and increase glucose glucose uptake

Answer 25

a. gluconeogensis and decrease glucose uptake

Question 26

effect of glucocorticoids in the muscle a. decrease protein synthesis and increase protein breakdown to provide amino acids for gluconeogenesis b. increase protein synthesis and decreased protein breakdown c. decrease glucose uptake and utilisation and increased gluconeogenesis

Answer 26

a. decreased protein synthesis and increased protein sy thesis to provide amino acids for gluconeogenesis

Question 27

what part of HPA axis is pathological in Addisons disease and what does this cause? a. pituatary , increased glucocorticoid b. hypothalamus, decreased glucocorticoid c. adrenal glands, decreased glucocorticoid d. adrenal glands, decreased glucocorticoid

Answer 27

c. adrenal glands, decrease glucocorticoid

Question 28

what drugs are used for replacement therapy in Addisons? a. prednisolone(GC) and dexamethosone (GC) b. hydrocortisone (GC) and fludrocortisone(MC) c. Prednisolone (GC) and fludrocortisone (MC)

Answer 28

b hydrocortisone (GC) and fludrocortisone (MC)

Question 29

topical administration of methylprednisolone and dexamthosone are used to treat what condition/s? a. addisons and cushings b. eczema, allergic conjunctivitis, rhinitis c. asthma

Answer 29

b.eczema, allergic conjunctivitis, rhinitis

Question 30

which corticosteroid is used to treat rheumatoid arthritis? a. prednisolone and beclomethasone b. hydrocortisone and fludrocortisone c. methylprednisolone and dexamathosone

Answer 30

c. methylprednisolone and dexamethasone

Question 31

how are glucocoticoids used in cancer patients? a. combination with cytotoxic drugs, reducing cerebral oedema , anti emetic therapy, weigh gain in cachexia b. immunosuppression and weight gain c. anti inflammatory and pain relief

Answer 31

a.combination with cytotoxic drugs, reducing cerebral oedema , anti emetic therapy, weigh gain in cachexia

Question 32

what condition is indicated by stripes on nails, bronzed skin, postural hypotension, hypoglycaemia and weakness? a. cushings b. Addisons

Answer 32

b.addisons

Question 33

how are steroids administered to treat carpal tunnel syndrome? a. Injection b. topical c. oral

Answer 33

a.injection

Question 34

calor, rubor, tumor, dolor and junco lapsa refer to the stages of what process? a. pain management b. inflammation c. immunosuppression d. protein expression

Answer 34

b. inflammation

Question 35

corticosteroids reduce inflammation by reducing numbers of what type of WBC? a. leukocytes and macrophages b. T helper CD4 cells and leukocytes c. Macrophages and T helper CD4 cells

Answer 35

C.macrophages and CD4 cells

Question 36

what lymphocyte activators have a production decreased by the action corticosteroids ? a.IL1 IL2 B. IL3 IL4 C IL4 IL5 D. IL4 IL5

Answer 36

a. IL1 IL2

Question 37

inhibitor of AP1 and NFkB signalling by glucocorticoids lead to decreased transcription of what ? a. COX 2 PLA2 IL2R b. COX3 PLA2 IL2R c. COX3 PLA2 IL2R

Answer 37

a. COX2 PLA2 IL2R

Question 38

what enzyme converts lipocortin (annexing 1) to arachadonic acid? a. calcium phosphatase b. cyclooxyrgenase c. phospholipase A2

Answer 38

c.phospholipase A2

Question 39

what enzyme does corticosteroids inhibit to suppress chronic inflammation? a. COX b. phospholipase A2 c. phospholipase A3 d. phospholipase A4

Answer 39

b. phospholipase A2

Question 40

Whta does cyclooxyrgenase do? a. convert arachidonic acid to prostaglandins and leukotrienes b. produce arachadonic acid from cell membrane phospholipids

Answer 40

a. convert arachidonic acid to prostaglandins and leukotrienes

Question 41

what is key when stopping a course of glucocorticoids? a. switching to a weaker steroid b. phased withdrawal c. sudden withdrawal d. switching to a different type of drug to relieve pain

Answer 41

b. phased withdrawal

Question 42

what condition can arise from systemic use of corticosteroid therapy? a. addisons b. cushings

Answer 42

b. bushings

Question 43

which of these are the correct symptoms and signs of cushings ? a. hypertension, buffalo hump, abdominal fat, moon face b. bronzed skin, stripes on nails, weight loss, hypotension c. moon face, hypotension, buffalo humo, abdominal fat

Answer 43

a. hypertension, buffalo hump, abdominal fat, moon face and cataracts

Question 44

what type of administration of corticosteroids increases risk of oral candidiasis, pneumonia, blood glucose ? a. oral b. IV c. IM d. Inhaled

Answer 44

d.inhaled

Question 45

which glucocorticoid would cause increased neutrophils on a FBC? a. prednisolone b. aldosterone c. hydrocortisone d. dexamethasone

Answer 45

a.prednisolone

Question 46

what hormone of the HPA axis is increased in Cushings ? a. CRH b. ACTH c. MC

Answer 46

b. ACTH

Question 47

excess steroid production eg bushings leads to what effect on muscle mass? a. increase b. decrease c. weakness d. strength

Answer 47

b/c . weakness and loss

Question 48

insufficient steroid production eg in addisons has what effect on muscle mass? a. increase b. decrease

Answer 48

b.decrease

Question 49

what type of steroids increase muscle mass? a. GC b. MC c. anabolic

Answer 49

c.anabolic