Drugs Used in Adrenal Disorders: Master Pharmacology Concepts

Question 1

Mineralocorticoids primarily exert their effects on which organ?

Accepted Answer

Kidney

Answer

Heart

Answer

Liver

Answer

Adrenal gland

Question 2

Which of the following is NOT a mechanism of action of corticosteroids?

Accepted Answer

Activation of beta-adrenergic receptors

Answer

Inhibition of phospholipase A2

Answer

Induction of lipocortin-1

Answer

Stabilization of lysosomal membranes

Question 3

Which route of administration is preferred for rapid replacement of corticosteroids in Addisonian crisis?

Accepted Answer

Intravenous

Answer

Oral

Answer

Intramuscular

Answer

Subcutaneous

Question 4

Which of the following corticosteroids has the highest glucocorticoid potency?

Accepted Answer

Dexamethasone

Answer

Prednisone

Answer

Hydrocortisone

Answer

Fludrocortisone

Question 5

Which of the following enzymes is inhibited by corticosteroids?

Accepted Answer

Phospholipase A2

Answer

Cyclooxygenase

Answer

Lipoxygenase

Answer

5-lipoxygenase

Question 6

Which of the following is NOT a synthetic glucocorticoid?

Accepted Answer

Cortisol

Answer

Prednisolone

Answer

Dexamethasone

Answer

Fludrocortisone

Question 7

How do corticosteroids interact with anticoagulants to increase the risk of gastrointestinal bleeding?

Accepted Answer

Corticosteroids inhibit prostaglandin synthesis, which normally protects the gastrointestinal lining, making it more susceptible to anticoagulant-induced damage.

Answer

Corticosteroids increase anticoagulant absorption, leading to increased blood clot formation.

Answer

Anticoagulants increase corticosteroid absorption, resulting in higher plasma levels and an accumulation of adverse effects.

Answer

Corticosteroids and anticoagulants do not have any significant interactions.

Question 8

Which of the following is NOT a mechanism of action of corticosteroids?

Accepted Answer

Activation of phospholipase C

Answer

Inhibition of phospholipase A2

Answer

Induction of lipocortin-1

Answer

Stabilization of lysosomal membranes

Question 9

Which mineralocorticoid is used as initial treatment for primary aldosteronism?

Accepted Answer

Spironolactone

Answer

Eplerenone

Answer

Fludrocortisone

Answer

Dexamethasone

Question 10

The main glucocorticoid produced by the adrenal cortex is:

Accepted Answer

Cortisol

Answer

Aldosterone

Answer

Corticosterone

Answer

Prednisone

Question 11

The rate-limiting enzyme in the synthesis of aldosterone is:

Accepted Answer

CYP11A1

Answer

11β-hydroxylase

Answer

CYP17A1

Answer

21-hydroxylase

Question 12

What is the primary target organ for mineralocorticoids?

Accepted Answer

Kidney

Answer

Liver

Answer

Heart

Answer

Central nervous system

Question 13

Which of the following is NOT an indication for glucocorticoid therapy?

Accepted Answer

Type 1 diabetes

Answer

Rheumatoid arthritis

Answer

Asthma

Answer

Multiple sclerosis

Question 14

The synthesis and release of corticosteroids is primarily regulated by:

Accepted Answer

ACTH

Answer

Adrenaline

Answer

Noradrenaline

Answer

Dopamine

Question 15

Which of the following accurately describes the primary mechanism of action of glucocorticoids?

Accepted Answer

Inhibition of phospholipase A2, resulting in decreased production of inflammatory mediators

Answer

Stimulation of beta-adrenergic receptors, leading to increased heart rate and blood pressure

Answer

Activation of protein kinase A, promoting cell growth and differentiation

Answer

Blockade of ion channels, inhibiting nerve impulse transmission

Question 16

Which of the following is NOT a valid clinical application of mineralocorticoids?

Accepted Answer

Prevention of migraine headaches, a condition not typically associated with mineralocorticoid deficiency

Answer

Replacement therapy in Addison's disease, correcting electrolyte imbalances and restoring blood pressure

Answer

Management of hyperkalemia, promoting potassium excretion and preventing life-threatening arrhythmias

Answer

Replacement therapy in congenital adrenal hyperplasia, restoring normal adrenal function and hormone levels

Question 17

Which of the following synthetic glucocorticoids possesses the highest potency?

Accepted Answer

Dexamethasone, a potent synthetic glucocorticoid used in severe inflammatory conditions

Answer

Prednisone, a commonly used oral glucocorticoid with moderate potency

Answer

Hydrocortisone, a natural glucocorticoid with relatively low potency

Answer

Beclomethasone, a topical glucocorticoid used for localized inflammation

Question 18

Which of the following synthetic compounds is an analogue of aldosterone, the primary mineralocorticoid produced by the adrenal glands?

Accepted Answer

Fludrocortisone, a synthetic mineralocorticoid used to treat Addison's disease and other conditions

Answer

Desoxycorticosterone acetate, a naturally occurring mineralocorticoid used historically for Addison's disease

Answer

Canrenone, a potassium-sparing diuretic used to treat hypertension and edema

Answer

Eplerenone, a selective mineralocorticoid receptor antagonist used to treat heart failure

Question 19

Which of the following routes of administration is NOT commonly used for glucocorticoids?

Accepted Answer

Subcutaneous, a route rarely used for glucocorticoids

Answer

Oral, a convenient route for chronic or long-term therapy

Answer

Intravenous, used for immediate delivery in acute or severe conditions

Answer

Topical, applied directly to the skin for localized inflammation

Question 20

What is the primary mechanism of action of mineralocorticoids?

Accepted Answer

Binds to mineralocorticoid receptors in the distal convoluted tubules of the kidney, promoting sodium reabsorption and potassium excretion.

Answer

Activates adenylyl cyclase, increasing cAMP levels

Answer

Inhibits the activity of 11-beta-hydroxylase, reducing cortisol production

Answer

Binds to glucocorticoid receptors in the cytoplasm, inducing gene transcription

Question 21

Which adrenal disorder is characterized by excessive production of cortisol?

Accepted Answer

Cushing's syndrome

Answer

Addison's disease

Answer

Neuroblastoma

Answer

Pheochromocytoma

Question 22

What is the first-line treatment for primary adrenal insufficiency (Addison's disease)?

Accepted Answer

Hydrocortisone replacement therapy

Answer

Surgery

Answer

Mineralocorticoid replacement therapy

Answer

Adrenalectomy

Question 23

What is the primary indication for spironolactone therapy?

Accepted Answer

Treatment of primary hyperaldosteronism

Answer

Treatment of acne

Answer

Treatment of hypertension

Answer

Treatment of asthma

Question 24

Which of the following drugs is a synthetic mineralocorticoid?

Accepted Answer

Fludrocortisone

Answer

Spironolactone

Answer

Eplerenone

Answer

Prednisone

Question 25

What is the unique mechanism of action of eplerenone?

Accepted Answer

Selective blockade of mineralocorticoid receptors

Answer

Inhibition of angiotensin-converting enzyme

Answer

Stimulation of beta-adrenergic receptors

Answer

Activation of peroxisome proliferator-activated receptors

Question 26

What is the most common adverse effect of mineralocorticoid replacement therapy?

Accepted Answer

Hypertension

Answer

Osteoporosis

Answer

Hypokalemia

Answer

Hyperglycemia