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MSK 1 > Pharmacology- pain mangement 2 ; corticosteroids > Flashcards

Pharmacology- pain mangement 2 ; corticosteroids Flashcards

1
Q

what is is targeted by corticosteroids?

a. muscles
b. HPA axis
c. heart

A

b. HPA axis

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2
Q

what is the HPA axis made up of?

A

Hypothalamic pituitary adrenal glands

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3
Q

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

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

A

a.CRH

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4
Q

where ACTH hormone act?

a. hypothalamus
b. pituitary gland
c. adrenal glands

A

c.adrenal glands

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5
Q

what triggers the hypothalamus to release CRH?

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

A

b.stress and circadian rhythms

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6
Q

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

A

a.glomerulosa, fasciculata, reticularis

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7
Q

where are catecholamines produced?

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

A

a.inner medulla of adrenal cortex

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8
Q

where is the the glucocorticoid receptor expressed?

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

A

c.widely

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9
Q

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

A

a.epithelial cells, kidney, colon, bladder

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10
Q

what is the main use of glucocorticoids?

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

A

a.anti inflammatory and pain relief

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11
Q

what type of corticosteroid regulates electrolyte balance in the kidney

a. mineralcorticoids
b. glucocorticoids

A

a. mineralocorticoids

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12
Q

what are the structures of corticosteroids based on?

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

A

b.cholesterol

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13
Q

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

a. glucocorticoids
b. mineralocorticoids

A

a.glucocorticoids

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14
Q

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

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

A

b.beclomethasone

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15
Q

which glucocorticoid is the most potent?

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

A

d.dexamethosone

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16
Q

where is the glucocorticoids receptor found?

a. in the cytoplasm
b. in the plasma membrane

A

a. in the cytoplasm

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17
Q

what type of corticosteroid has an anti insulin effect?

a. mineralocorticoids
b. glucocorticoids

A

b.glucocorticoids

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18
Q

aldosterone and fludrocortisone are examples of what type of corticosteroid?

a. mineralocorticoids
b. glucocorticoids

A

a.mineralocorticoids

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19
Q

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

a. glucocorticoid
b. mineralocorticoid

A

b.mineralocorticoid

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20
Q

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

a. glucocorticoid
b. mineralocorticoid

A

b, mineralocorticoid

21
Q

Whta is the mechanism of action of glucocorticoid?

A 
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
22
Q

how does the glucocorticoid receptor identify its target genes?

A

GC receptor binds to specific hormone response elements on target genes

23
Q

key actions of glucocorticoids

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

A

a. anti inflam, immunosupressive, metabolic

24
Q

what metabolism is affected by glucocorticoids?

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

A

b.carbohydrate and protein metabolism

25
Q

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

A

a. gluconeogensis and decrease glucose uptake

26
Q

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

A

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

27
Q

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

A

c. adrenal glands, decrease glucocorticoid

28
Q

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)

A

b hydrocortisone (GC) and fludrocortisone (MC)

29
Q

topical administration of methylprednisolone and dexamthosone are used to treat what condition/s?

a. addisons and cushings
b. eczema, allergic conjunctivitis, rhinitis
c. asthma

A

b.eczema, allergic conjunctivitis, rhinitis

30
Q

which corticosteroid is used to treat rheumatoid arthritis?

a. prednisolone and beclomethasone
b. hydrocortisone and fludrocortisone
c. methylprednisolone and dexamathosone

A

c. methylprednisolone and dexamethasone

31
Q

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

A

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

32
Q

what condition is indicated by stripes on nails, bronzed skin, postural hypotension, hypoglycaemia and weakness?

a. cushings
b. Addisons

A

b.addisons

33
Q

how are steroids administered to treat carpal tunnel syndrome?

a. Injection
b. topical
c. oral

A

a.injection

34
Q

calor, rubor, tumor, dolor and junco lapsa refer to the stages of what process?

a. pain management
b. inflammation
c. immunosuppression
d. protein expression

A

b. inflammation

35
Q

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

A

C.macrophages and CD4 cells

36
Q

what lymphocyte activators have a production decreased by the action corticosteroids ?

a.IL1 IL2
B. IL3 IL4
C IL4 IL5
D. IL4 IL5

A

a. IL1 IL2

37
Q

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

A

a. COX2 PLA2 IL2R

38
Q

what enzyme converts lipocortin (annexing 1) to arachadonic acid?

a. calcium phosphatase
b. cyclooxyrgenase
c. phospholipase A2

A

c.phospholipase A2

39
Q

what enzyme does corticosteroids inhibit to suppress chronic inflammation?

a. COX
b. phospholipase A2
c. phospholipase A3
d. phospholipase A4

A

b. phospholipase A2

40
Q

Whta does cyclooxyrgenase do?

a. convert arachidonic acid to prostaglandins and leukotrienes
b. produce arachadonic acid from cell membrane phospholipids

A

a. convert arachidonic acid to prostaglandins and leukotrienes

41
Q

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

A

b. phased withdrawal

42
Q

what condition can arise from systemic use of corticosteroid therapy?

a. addisons
b. cushings

A

b. bushings

43
Q

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

A

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

44
Q

what type of administration of corticosteroids increases risk of oral candidiasis, pneumonia, blood glucose ?

a. oral
b. IV
c. IM
d. Inhaled

A

d.inhaled

45
Q

which glucocorticoid would cause increased neutrophils on a FBC?

a. prednisolone
b. aldosterone
c. hydrocortisone
d. dexamethasone

A

a.prednisolone

46
Q

what hormone of the HPA axis is increased in Cushings ?

a. CRH
b. ACTH
c. MC

A

b. ACTH

47
Q

excess steroid production eg bushings leads to what effect on muscle mass?

a. increase
b. decrease
c. weakness
d. strength

A

b/c . weakness and loss

48
Q

insufficient steroid production eg in addisons has what effect on muscle mass?

a. increase
b. decrease

A

b.decrease

49
Q

what type of steroids increase muscle mass?

a. GC
b. MC
c. anabolic

A

c.anabolic

MSK 1 (23 decks)

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