Question 1

Hyposecretion of cortisol is associated with:&#10;A)an elevation in blood pressure&#10;B)increased fat deposition in certain areas (truncal obesity and buffalo hump)&#10;C)Addison's disease&#10;D)Cushing's syndrome

Accepted Answer

Hyposecretion of cortisol is associated with Addison's disease, which is characterized by a deficiency of adrenal hormones, including cortisol.

Question 2

Adrenocorticotropic hormone is released by the:&#10;A)anterior portion of the pituitary gland&#10;B)posterior portion of the pituitary gland&#10;C)cortex of the adrenal gland&#10;D)medulla of the adrenal gland

Accepted Answer

Adrenocorticotropic hormone (ACTH) is released by the anterior portion of the pituitary gland to stimulate the release of cortisol from the cortex of the adrenal gland.

Question 3

______________________ is/are the usual cause(s)of death with acute adrenal insufficiency.&#10;A)Metabolic acidosis&#10;B)Peristalsis&#10;C)Peripheral vascular collapse and ventricular asystole&#10;D)Respiratory depression

Accepted Answer

Peripheral vascular collapse and ventricular asystole are the usual cause of death in acute adrenal insufficiency, due to the lack of cortisol and aldosterone leading to decreased vascular tone and volume, and electrolyte imbalances. Metabolic acidosis and respiratory depression may also occur, but they are not the primary cause of death. Peristalsis is not related to adrenal insufficiency.

Question 4

Clinical manifestations of adrenal insufficiency include:&#10;A)weight gain&#10;B)hypertension&#10;C)hyperpigmentation&#10;D)hypokalemia

Accepted Answer

Hyperpigmentation is a classic sign of adrenal insufficiency because of increased production of melanocyte-stimulating hormone (MSH) due to deficiency of adrenal hormones. Weight loss, hypotension, and hypokalemia are more common clinical manifestations. Hypertension is not a characteristic feature of adrenal insufficiency.

Question 5

The adrenal cortices of normal adults secrete about ___ mg of cortisol daily.&#10;A)0.1&#10;B)2.0&#10;C)10&#10;D)20

Accepted Answer

The normal daily secretion of cortisol in the adrenal cortices of adults is approximately 20 mg.

Question 6

A patient with acute adrenal insufficiency usually exhibits:&#10;A)hypotension and tachycardia&#10;B)hypertension and tachycardia&#10;C)hypotension and bradycardia&#10;D)hypertension and bradycardia

Accepted Answer

Acute adrenal insufficiency, also known as an Addisonian crisis, is characterized by a sudden deficiency of cortisol and aldosterone. This can lead to hypotension (low blood pressure) and tachycardia (rapid heartbeat) due to decreased vascular tone and decreased cardiac output. Choice B (hypertension and tachycardia) and Choice D (hypertension and bradycardia) are not consistent with the physiological response to adrenal insufficiency. Choice C (hypotension and bradycardia) may be seen in severe cases, but is not the typical presentation.

Question 7

Definitive care for a patient with acute adrenal insufficiency will include administration of:&#10;A)epinephrine&#10;B)a source of &#34;sugar&#34;&#10;C)glucocorticosteroid&#10;D)a vasopressor

Accepted Answer

Acute adrenal insufficiency, also known as Addisonian crisis, is a life-threatening condition characterized by low levels of cortisol and aldosterone. The definitive treatment includes administration of a glucocorticosteroid such as hydrocortisone or dexamethasone, which replaces the deficient hormone and stabilizes the patient's condition. Epinephrine and vasopressors may be used in cases of hypotension, but they do not address the underlying cause of the crisis. A source of "sugar" may also be needed initially to treat hypoglycemia, but it is not considered part of the definitive care.

Question 8

In the dental setting,an acute episode of adrenal insufficiency will be marked most notably by:&#10;A)bradycardia&#10;B)severe mental confusion&#10;C)hypocalcemia&#10;D)hypokalemia

Accepted Answer

Severe mental confusion is a notable symptom of acute adrenal insufficiency, along with other symptoms such as fatigue, weakness, gastrointestinal disturbances, and hypotension.

Question 9

Cortisol is secreted by the:&#10;A)liver&#10;B)pancreas&#10;C)cortex of the adrenal gland&#10;D)medulla of the adrenal gland

Accepted Answer

Cortisol is secreted by the cortex of the adrenal gland. The liver does secrete hormones such as insulin-like growth factor 1, but not cortisol. The pancreas secretes hormones such as insulin and glucagon, but not cortisol. The medulla of the adrenal gland secretes catecholamines such as epinephrine and norepinephrine, but not cortisol.

Question 10

Which of the following will most likely lead to a noticeable improvement of the patient with acute adrenal insufficiency?&#10;A)aromatic spirits of ammonia&#10;B)administration of glucocorticoid&#10;C)oxygen&#10;D)A,B,and C&#10;E)A and C

Accepted Answer

The administration of glucocorticoids is the most effective treatment for acute adrenal insufficiency as it replaces the lacking hormones that the adrenal glands are unable to produce. Aromatic spirits of ammonia may help improve blood pressure, but it will not directly address the underlying hormonal deficiency. Oxygen may be needed in some cases, but it will not treat the underlying problem of adrenal hormone deficiency.

Deck 8: Acute Adrenal Insufficiency