Deck 16: Adrenocorticosteroids

Question 1

Which is released by the adrenal cortex in response to the release of adrenocorticotropic hormone (ACTH)?

A)Corticotropin-releasing hormone (CRH)
B)Hydrocortisone
C)Adrenocorticotropic hormone ACTH
D)Norepinephrine
E)Acetylcholine

Answer 1

Hydrocortisone

Question 2

The most extensive use of the corticosteroids in both medicine and dentistry is in

A)replacement therapy for corticosteroid deficiency.
B)cancer chemotherapy.
C)to prevent organ transplant rejection.
D)osteoporosis.
E)inflammatory and allergic conditions.

Answer 2

inflammatory and allergic conditions.

Question 3

Patients taking corticosteroids may have mucosal surfaces that are more _____ than other patients.

A)calloused
B)friable
C)keratinized
D)stippled

Answer 3

friable

Question 4

Which of the following choices is a disease or condition produced by an excess of adrenocorticosteroids?

A)Addison disease
B)Cushing syndrome
C)Graves' disease
D)Parkinson disease

Question 5

Of the following agents listed,which is the most potent in glucocorticoid activity?

A)Hydrocortisone (Cortaid,Anusol,Hytone,Dermacort,Penecort,Cetacort)
B)Fluocinolone acetonide (Synalar)
C)Betamethasone valerate (Valisone)
D)Triamcinolone acetonide (Aristocort)
E)Clobetasol propionate (Temovate)

Question 6

Adrenocorticosteroids are released from the

A)hypothalamus.
B)adrenal cortex.
C)pituitary gland.
D)adrenal medulla.
E)kidney.

Question 7

Which of the following statements is true concerning adrenal crisis?

A)Once adrenal suppression occurs,the adrenal gland will never respond normally again.
B)The adrenal crisis occurs because of a relative lack of corticosteroids during stress.
C)Administering adrenal steroids may be necessary after a stressful dental procedure to prevent adrenal crisis.
D)Problems generally occur with either low or very high doses,not in the midrange.

Question 8

ACTH is secreted from the _____ in response to _____.

A)hypothalamus;stress
B)adrenal cortex;corticotropin-releasing hormone (CRH)
C)adrenal cortex;stress
D)hypothalamus;hydrocortisone
E)pituitary gland;CRH

Question 9

Each of the following will be reduced by glucocorticoid excess except one.Which is the exception?

A)Secretion of growth hormone
B)Bone formation
C)Linear growth
D)Insulin resistance
E)Visceral obesity

Question 10

The mineralocorticoid effects of corticosteroids include all of the following except which one?

A)Increased sodium retention
B)Decreased potassium retention
C)Decreased bone density
D)Edema
E)Hypertension

Question 11

When does the maximal secretion of hydrocortisone (cortisol)occur in the body?

A)Between 12 PM and 2 PM
B)Between 9 AM and 12 AM
C)Between 4 AM and 8 AM
D)Between 7 AM and 10 AM

Question 12

For which type of oral lesion would glucocorticoids be contraindicated?

A)Desquamative gingivitis
B)Herpetic gingivostomatitis
C)Pemphigus
D)Erythema multiforme
E)Benign mucous membrane pemphigoid

Question 13

All of the following are signs of Cushing syndrome except for which one?

A)Moon face
B)Hypoglycemia
C)Muscle wasting
D)Fat deposit on back of neck

Question 14

Negative feedback involves the action of adrenocorticosteroids on the

A)adrenal cortex.
B)pituitary gland.
C)hypothalamus.
D)Both A and C are correct.
E)Both B and C are correct.

Question 15

Without stress,the normal adult secretes approximately _____ of hydrocortisone daily.

A)20 mg
B)40 mg
C)5 mg
D)40 Mg
E)10 mg

Question 16

Patients who are on which of the following corticosteroid regimens should be prescribed supplemental corticosteroids before a stressful dental procedure?

A)Currently taking less than 20 mg of hydrocortisone every day
B)Currently taking more than 40 mg of hydrocortisone every day
C)Currently taking between 20 and 40 mg of hydrocortisone every day
D)All of the above
E)None of the above

Question 17

A 5-mg oral dose of hydrocortisone (Cortisol)would be equivalent to what dose of triamcinolone?

A)1 mg
B)2 mg
C)5 mg
D)10 mg
E)20 mg

Question 18

Which of the following types of patients is least likely to require steroid supplementation for most routine dental procedures?

A)A patient with primary adrenal insufficiency
B)A patient with secondary adrenal insufficiency
C)A patient with Addison disease
D)A patient with rheumatoid arthritis

Question 19

Glucocorticoids cause an increase in the circulating levels of which of the following white blood cells?

A)T lymphocytes
B)B lymphocytes
C)Neutrophils
D)Basophils
E)Monocytes

Question 20

The inflammatory activity of the adrenocorticosteroids may cause them to mask the symptoms of an infection.Adrenocorticosteroids decrease a patient's ability to fight infection by suppression of migration of plasma cells.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true;the second statement is false.
D)The first statement is false;the second statement is true.

Question 21

Inhibition of phospholipase A by steroids leads to decreased production of (Select all that apply. )

A)neutrophils.
B)prostaglandins.
C)arachidonic acid.
D)leukotrienes.

Question 22

A deficiency of adrenocorticosteroids is ________,and an excess is __________.

A)Addison disease;Cushing disease
B)Addison disease;Cushing syndrome
C)Addison syndrome;Cushing syndrome
D)Addison syndrome;Cushing disease

Question 23

Which of the following conditions may be exacerbated by corticosteroid use? (Select all that apply. )

A)Hypertension
B)Hypotension
C)Congestive heart failure
D)Glaucoma
E)Osteoporosis

Question 24

Adrenal crisis is a rare event in dentistry.

Question 25

The adverse effects of glucocorticoids are primarily an extension of their therapeutic actions.

Question 26

Corticosteroids increase resistance to infection.

Question 27

Levels of endogenous corticosteroids can increase tenfold in response to an especially stressful stimulus.

Question 28

Most dental patients taking steroids who are having normal dental treatment rendered do not need additional corticosteroids.

Question 29

Corticosteroids are mainly used in medicine and dentistry for treatment of which types of conditions?

A)Hypertension
B)Adult periodontitis
C)Osteoporosis
D)Inflammatory conditions