Adrenal & Pituitary
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Questions and Answers

Which corticosteroid has the highest glucocorticoid activity?

  • Dexamethasone (correct)
  • Prednisone
  • Cortisone
  • Hydrocortisone
  • What special administration instruction should be followed for patients receiving therapy for Cushing’s Syndrome?

  • Increase dosage with any signs of fever.
  • Monitor blood sugar levels regularly. (correct)
  • Take medication only when symptoms appear.
  • Administer medication with food.
  • Which of the following medications is a dopamine agonist used in the treatment of hyperprolactinemia?

  • Spironolactone
  • Bromocriptine (correct)
  • Mitotane
  • Metyrapone
  • Which medication is recognized for its mineralocorticoid activity?

    <p>Fludrocortisone</p> Signup and view all the answers

    What are the potential adverse effects common to corticosteroids?

    <p>Osteoporosis and hypertension</p> Signup and view all the answers

    Which CYP450 isoforms are primarily affected by ketoconazole?

    <p>CYP3A4 and CYP2C19</p> Signup and view all the answers

    What is a primary goal of treatment for adrenal insufficiency?

    <p>Replace deficient hormones.</p> Signup and view all the answers

    What is a common misconception regarding the treatment of Cushing’s syndrome?

    <p>Symptoms will resolve without ongoing therapy.</p> Signup and view all the answers

    What unique property does mitotane possess in relation to the adrenal cortex?

    <p>It causes atrophy and degeneration of the adrenal cortex.</p> Signup and view all the answers

    Which of the following is a potential adverse effect of ketoconazole and levoketoconazole?

    <p>Severe hepatic injury</p> Signup and view all the answers

    What is a common result of inhibiting the synthesis of aldosterone?

    <p>Increased mineralocorticoid activity</p> Signup and view all the answers

    Metyrapone and orlisodrostat can have which additional activity due to their actions on cortisol precursors?

    <p>Androgenic activity</p> Signup and view all the answers

    Which metabolic pathways primarily metabolize metyrapone?

    <p>Non-CYP450 enzymes</p> Signup and view all the answers

    What types of adverse effects can metyrapone, mitotane, and osilodrostat induce?

    <p>Gastrointestinal and neurologic effects</p> Signup and view all the answers

    Why do steroidogenic inhibitors require careful monitoring of adverse effects?

    <p>They produce potent antisteroidogenic effects.</p> Signup and view all the answers

    Which of the following is NOT a isoform through which osilodrostat is metabolized?

    <p>CYP11A1</p> Signup and view all the answers

    What are the three general differences that corticosteroids exhibit relative to cortisol?

    <p>Potency, Glucocorticoid Activity, Mineralocorticoid Activity</p> Signup and view all the answers

    Which corticosteroid is known as an endogenous glucocorticoid and also marketed as a drug?

    <p>Hydrocortisone</p> Signup and view all the answers

    What effect do corticosteroids have that is specifically mentioned as important and will be covered in future courses?

    <p>Immunosuppression</p> Signup and view all the answers

    Small chemical modifications to cortisol result in what classifications of corticosteroids?

    <p>Different Potency, Glucocorticoid Activity, Mineralocorticoid Activity</p> Signup and view all the answers

    What is the main pharmacological activity of hydrocortisone?

    <p>Both mineralocorticoid and glucocorticoid activity</p> Signup and view all the answers

    What is the primary mechanism of action of ketoconazole in the treatment of Cushing's disease?

    <p>Inhibits cortisol production</p> Signup and view all the answers

    What percentage of patients may experience normalization of serum free cortisol levels with ketoconazole treatment?

    <p>Up to 70%</p> Signup and view all the answers

    Which of the following is NOT a side effect associated with ketoconazole treatment?

    <p>Hirsutism</p> Signup and view all the answers

    What is a critical monitoring requirement for patients taking ketoconazole?

    <p>Hepatic function tests</p> Signup and view all the answers

    Why should drug interactions be considered before starting ketoconazole therapy?

    <p>Ketoconazole is a potent inhibitor of cytochrome P450 isoforms</p> Signup and view all the answers

    What is a potential advantage of levoketoconazole compared to ketoconazole?

    <p>Decreased risk of liver toxicity</p> Signup and view all the answers

    What common side effects can result from metyrapone therapy?

    <p>Hirsutism and hypertension</p> Signup and view all the answers

    What is the starting recommended dose of ketoconazole for treating Cushing's disease?

    <p>200 mg PO BID or TID</p> Signup and view all the answers

    What effect does the 9-fluoro substituent have on the 11-hydroxy group in corticosteroids?

    <p>Increases the acidity of the hydroxyl group</p> Signup and view all the answers

    Which is a common short-term effect of corticosteroids?

    <p>Fluid retention</p> Signup and view all the answers

    What is a result of corticosteroids increasing the production of neutrophils?

    <p>Increased leukocytosis</p> Signup and view all the answers

    Which long-term effect is associated with the use of corticosteroids?

    <p>Hypertension</p> Signup and view all the answers

    What does corticosteroid therapy often lead to in terms of leukocyte levels?

    <p>Increased leukocyte count</p> Signup and view all the answers

    Which of the following corticosteroid effects can contribute to psychological changes?

    <p>Mood changes (psychosis)</p> Signup and view all the answers

    Which corticosteroid effect may lead to a condition of excessive appetite?

    <p>Cushing’s syndrome</p> Signup and view all the answers

    What adverse effect is commonly associated with corticosteroids in the short term?

    <p>Fluid retention</p> Signup and view all the answers

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