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 (A)</p> Signup and view all the answers

What are the potential adverse effects common to corticosteroids?

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

Which CYP450 isoforms are primarily affected by ketoconazole?

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

What is a primary goal of treatment for adrenal insufficiency?

<p>Replace deficient hormones. (B)</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. (D)</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. (B)</p> Signup and view all the answers

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

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

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

<p>Increased mineralocorticoid activity (C)</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 (A)</p> Signup and view all the answers

Which metabolic pathways primarily metabolize metyrapone?

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

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

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

Why do steroidogenic inhibitors require careful monitoring of adverse effects?

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

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

<p>CYP11A1 (C)</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 (A)</p> Signup and view all the answers

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

<p>Hydrocortisone (C)</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 (C)</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 (C)</p> Signup and view all the answers

What is the main pharmacological activity of hydrocortisone?

<p>Both mineralocorticoid and glucocorticoid activity (D)</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 (B)</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% (D)</p> Signup and view all the answers

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

<p>Hirsutism (A)</p> Signup and view all the answers

What is a critical monitoring requirement for patients taking ketoconazole?

<p>Hepatic function tests (D)</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 (C)</p> Signup and view all the answers

What is a potential advantage of levoketoconazole compared to ketoconazole?

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

What common side effects can result from metyrapone therapy?

<p>Hirsutism and hypertension (D)</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 (C)</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 (A)</p> Signup and view all the answers

Which is a common short-term effect of corticosteroids?

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

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

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

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

<p>Hypertension (D)</p> Signup and view all the answers

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

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

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

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

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

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

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

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

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