Deck 36: Gonadal Hormones and the Oral Contraceptives

Question 1

What is the main purpose of undergoing alternate-day therapy in cases where the prolonged use of steroids is necessary?

A) Alternate-day therapy is intended to reduce or eliminate the adverse effects of prolonged steroid treatment.
B) Alternate-day therapy is intended to facilitate treatment for patients with hectic or busy lifestyles.
C) Alternate-day therapy is intended to reduce or eliminate the stress on the liver that must metabolize the glucocorticoids.
D) All of these are correct.

Answer 1

Alternate-day therapy is intended to reduce or eliminate the adverse effects of prolonged steroid treatment.

Question 2

Summarize the relationship between the hypothalamus,the anterior pituitary gland,and the adrenal gland.

A) The hypothalamus secretes ACTH (adrenocorticotropic hormone), which stimulates the release of CRH (corticotropin-releasing hormone) from the anterior pituitary gland that leads to the secretion of glucocorticoids by the adrenal gland.
B) The hypothalamus secretes CRH (corticotropin-releasing hormone), which stimulates the release of ACTH (adrenocorticotropic hormone) from the anterior pituitary gland that leads to the secretion of mineralocorticoids by the adrenal gland.
C) The hypothalamus secretes CRH (corticotropin-releasing hormone), which stimulates the release of ACTH (adrenocorticotropic hormone) from the anterior pituitary gland that leads to the secretion of glucocorticoids by the adrenal gland.
D) None of these are correct.

Answer 2

The hypothalamus secretes CRH (corticotropin-releasing hormone), which stimulates the release of ACTH (adrenocorticotropic hormone) from the anterior pituitary gland that leads to the secretion of glucocorticoids by the adrenal gland.

Question 3

Which of the following statements is true about glucocorticoids?

A) Both native and synthetic glucocorticoids are metabolized by the liver and excreted in the urine.
B) The most common urinary metabolites of cortisol are the 17-hydroxycorticosteroids (17-OHCS).
C) The metabolites of cortisol can be measured from 24-hour urine collections and are used to provide an estimate of glucocorticoid secretion from the adrenal cortex.
D) All of these statements are correct.

Answer 3

All of these statements are correct.

Question 4

Which of the following factors contributes to stress?

A) Infection
B) Cold weather
C) Surgery
D) All of the above

Question 5

High doses or long-term treatment with hydrocortisone generally results in:

A) the abnormal deposition of fat in the face and along the shoulders.
B) the abnormal deposition of fat in the hips and buttocks.
C) the redistribution of fat in the body to the chest and stomach regions.
D) all of these.

Question 6

As a health-care professional,which of the following instructions will Dr.Knightley give a patient with lupus erythematosus who intends to discontinue long-term therapy with prednisone?

A) He will tell him to gradually reduce the dose of prednisone over a period of a few months.
B) He will tell him to stop taking prednisone immediately.
C) He will tell him to keep reducing the dose of prednisone every other day until he is no longer dependent on the drug.
D) None of these are correct.

Question 7

Repository preparations of drugs:

A) have a quick onset of action.
B) have a long duration of action.
C) are usually made for intravenous administration.
D) are water soluble.

Question 8

Which of the following symptoms is associated with the excessive use of aldosterone?

A) Hypotension
B) Hypertension
C) Low blood pressure
D) None of these

Question 9

Identify a difference between the adrenal medulla and the adrenal cortex.

A) The adrenal medulla forms the outer portion of the adrenal glands, while the adrenal cortex forms the inner portion of the adrenal glands.
B) The adrenal medulla develops from the same tissue as sympathetic ganglia, while the adrenal cortex develops from mesodermal tissue.
C) The adrenal medulla secretes three types of steroids, while the adrenal cortex secretes only catecholamines.
D) The adrenal medulla is composed of three separate layers of tissue, while the adrenal cortex is composed of a single layer of tissue.

Question 10

Where are the adrenal glands located?

A) On the upper surface of each kidney
B) At the base of the brain
C) On the anterior side of the neck
D) On the lower surface of the left kidney

Question 11

Which of the following statements is true about the adrenocorticotropin hormone (ACTH)?

A) ACTH cannot stimulate aldosterone secretion.
B) ACTH is released from the hypothalamus.
C) ACTH stimulates the adrenal cortex to secrete cortisol and cortisone.
D) ACTH is secreted in smaller amounts during periods of stress.

Question 12

Which of the following is true of the mechanism of action of aldosterone?

A) Aldosterone increases the reabsorption of sodium ions and water; in exchange, potassium ions are transported into the urine.
B) Aldosterone increases the discharge of sodium ions and water into the urine.
C) Aldosterone increases the reabsorption of potassium ions and water; in exchange, sodium ions are transported into the urine.
D) None of these are correct.

Question 13

After Darren breaks his ribs in a car accident,he is admitted at Pascal Hospital for a few days under the care of Dr.Palmer.Which of the following changes will Dr.Palmer expect in Darren's body as a response to the trauma of the accident?

A) An increase in the level of glucose in the blood plasma
B) An increase in the synthesis of proteins in the skeletal muscles
C) A decrease in sodium and water retention
D) A decrease in the level of glucose in the blood plasma

Question 14

The process of gluconeogenesis primarily occurs in _____.

A) the cortex of the kidneys
B) the liver
C) skeletal muscles
D) bone marrow

Question 15

Which of the following statements is true of mineralocorticoids?

A) Mineralocorticoids are secreted by the zona fasciculata of the adrenal cortex.
B) A deficiency in mineralocorticoid production may lead to Cushing's disease.
C) The main function of the mineralocorticoid hormones is to stimulate gluconeogenesis and lipolysis.
D) The main function of the mineralocorticoid hormones is to regulate blood levels of sodium and potassium.

Question 16

Maddison experiences muscle weakness and dehydration and visits Dr.Clark's clinic for a medical checkup.Dr.Clark runs a couple of tests and discovers that Maddison has hypotension.After examining Maddison's medical reports,Dr.Clark orders the administration of the adrenocorticotropin hormone (ACTH)and then proceeds to measure the plasma levels of cortisol and 17-hydroxycorticosteroids (17-OHCS)in Maddison's bloodstream.When he observes no change in the levels of these steroids,he diagnoses Maddison with a particular condition.Based on the information provided in this scenario,from which of the following conditions is Maddison most likely suffering?

A)Hashimoto's thyroiditis
B)Cushing's disease
C)Tourette's syndrome
D)Addison's disease

Question 17

Identify the hormone that is secreted by the anterior pituitary gland in response to the secretion of the corticotropin-releasing hormone (CRH)by the hypothalamus.

A) Aldosterone
B) Adrenocorticotropin hormone
C) Dehydroepiandrosterone
D) Cortisol

Question 18

Which of the following is true of catabolism?

A) Catabolism primarily occurs in the skeletal muscle.
B) Catabolism refers to the process of synthesizing complex compounds from simpler molecules.
C) Catabolism primarily occurs in the liver.
D) Catabolism is not associated with the release of energy.

Question 19

_____ refers to a process that is associated with energy release in which complex compounds are broken down into simpler molecules.

A) Anabolism
B) Catabolism
C) Gluconeogenesis
D) Constructive metabolism

Question 20

Which of the following is true of gluconeogenesis?

A) Gluconeogenesis refers to the synthesis of glucose from carbohydrates.
B) Gluconeogenesis refers to the process of converting glycerol and amino acids into glucose.
C) Gluconeogenesis primarily occurs in the skeletal muscles.
D) Gluconeogenesis leads to a decrease in plasma glucose concentration.

Question 21

Which of the following conditions results from a deficiency of mineralocorticoids?

A) Cushing's syndrome
B) Hypoaldosteronism
C) Hyperaldosteronism
D) Tourette's syndrome

Question 22

The most important secreted mineralocorticoid is _____.

A) hydrocortisone
B) aldosterone
C) betamethasone
D) estradiol

Question 23

Which of the following is true of aldosterone?

A) Aldosterone is the most important secreted glucocorticoid.
B) Aldosterone decreases the reabsorption of sodium ions through sodium channels.
C) Aldosterone secretion is inhibited by small increases in the potassium ion level in the blood.
D) Aldosterone receptors are present in the epithelial cells of organs such as the kidneys, colon, heart, and sweat glands.

Question 24

Who among the following should avoid using steroids?

A) Emma, who has allergic rhinitis
B) Alex, who has ocular herpes
C) Fred, who has rheumatoid arthritis
D) Pablo, who has asthma

Question 25

Angela develops a skin rash after using a new brand of facial cream.She decides to buy a nonprescription drug from a chemist to suppress the skin inflammation.Which of the following drugs is the chemist most likely to give her?

A) An intramuscular injection of triamcinolone
B) A topical hydrocortisone product
C) Prednisolone tablets
D) Mometasone nasal spray

Question 26

Select the most appropriate reason why a patient on warfarin therapy should not use glucocorticoids.

A) Because glucocorticoids can inhibit the body's response to warfarin
B) Because warfarin can inhibit the action of glucocorticoids
C) Because glucocorticoids can increase the requirement for warfarin
D) None of above

Question 27

Which of the following adverse effects is most likely to result from the excessive use of mineralocorticoids?

A) Increased gluconeogenesis
B) Sodium and water retention and loss of potassium
C) Increased protein catabolism
D) None of these

Question 28

Identify an adverse effect of glucocorticoids.

A) Decrease in sweating
B) Decrease in appetite
C) Weight loss
D) Restlessness

Question 29

_____ is the only steroid approved for nonprescription products.

A) Hydrocortisone
B) Fluticasone
C) Dexamethasone
D) Budesonide

Question 30

Which of the following is true of the anti-inflammatory activity of glucocorticoids?

A) Glucocorticoids are the least potent anti-inflammatory agents available.
B) Glucocorticoids interfere with a specific stage of the inflammatory response.
C) Glucocorticoids require a transport binding globulin to carry them to the target tissue.
D) Glucocorticoids tend to have a greater effect on B-cells and T-cells than they have on macrophages.

Question 31

What information must be given to a female patient who is on steroid therapy and who has just learned that she is pregnant?

A) If she is going to continue treatment, the infant will have to be monitored for adrenal function after birth.
B) Chronic maternal steroid use in the first trimester can result in a cleft palate in newborns (about 1 percent incidence).
C) If she is going to continue treatment, her dose will have to be reduced to the lowest possible effective dose.
D) All of these are correct.

Question 32

As a health-care professional,which of the following guidelines will you have to bear in mind while counseling patients who are receiving steroid therapy?

A) Single steroid doses should be taken before 9 AM to allow distribution of drug to mimic diurnal levels without suppressing available adrenocortical activity.
B) Patients receiving high-dose or long-term steroid therapy should not discontinue the steroids without the supervision of the prescribing physician to avoid precipitating symptoms of withdrawal.
C) Diabetics may have an increased blood glucose concentration requiring dose adjustment in insulin or oral antidiabetic drugs.
D) All of these statements are correct.

Question 33

Identify an accurate statement about mineralocorticoids.

A) The mineralocorticoids are hormones secreted by the innermost layer of the adrenal gland.
B) The main effect of the mineralocorticoid hormones is to regulate the fluid balance of the body.
C) The most important secreted mineralocorticoid is hydrocortisone.
D) The excessive use of mineralocorticoids often leads to obesity and diabetes mellitus.

Question 34

Cosyntropin is a synthetic peptide that:

A) corresponds to an inactive segment of ACTH.
B) provides the same therapeutic activity as ACTH.
C) has more allergenic potential than ACTH.
D) has a broader range of uses than ACTH.

Question 35

In which of the following patients is the use of steroids contraindicated?

A)Patients suffering from gastrointestinal ulcers
B)Patients who have systemic fungal and local herpes infections
C)Patients suffering from renal disease
D)Patients suffering from colitis