Question 1

Glucocorticoids should be withdrawn slowly after several weeks or months of use,because the ______ needs time to resume normal function when these drugs are discontinued.&#10;A)liver&#10;B)kidneys&#10;C)adrenal gland&#10;D)thyroid gland&#10;E)pancreas

Accepted Answer

Glucocorticoids are synthetic drugs that mimic the effects of cortisol, which is a hormone produced by the adrenal gland. Prolonged use of these drugs suppresses the hypothalamic-pituitary-adrenal (HPA) axis, which regulates cortisol production. When the drugs are suddenly withdrawn, the adrenal gland may not be able to produce enough cortisol to meet the body's needs, leading to adrenal insufficiency or adrenal crisis. Therefore, it is recommended to withdraw the drugs slowly to allow the adrenal gland to gradually resume normal function.

Question 2

In general,steroids alter protein synthesis in responsive cells through a direct effect on the cell's:&#10;A)ribosomes.&#10;B)nucleus.&#10;C)golgi apparatus.&#10;D)mitochondria.&#10;E)lysosomes.

Accepted Answer

Steroids act on the nucleus of responsive cells to alter protein synthesis by binding to specific steroid hormone receptors (transcription factors), which then bind to specific DNA sequences (hormone response elements) in the promoter regions of target genes to enhance or inhibit their transcription. This leads to changes in the production of specific proteins by the cell.

Question 3

Glucocorticoids are released from the adrenal cortex:&#10;A)on a daily basis,usually around 8:00 a.m.in most humans.&#10;B)in response to stressful stimuli (trauma,fever,and so forth).&#10;C)in response to adrenocorticotropic hormone (ACTH)from the anterior pituitary.&#10;D)all of the above&#10;E)none of the above

Accepted Answer

Glucocorticoids are released from the adrenal cortex in response to stressful stimuli and also in response to adrenocorticotropic hormone (ACTH) from the anterior pituitary. However, they are also released on a daily basis, usually around 8:00 a.m. in most humans as part of the normal circadian rhythm. Therefore, option D is the best choice as it includes all the correct statements.

Question 4

From a physical therapy perspective,the most important adverse effect seen in patients taking systemic glucocorticoid (anti-inflammatory steroid)drugs is:&#10;A)hypertension.&#10;B)aggravation of diabetes mellitus.&#10;C)aggravation of stomach ulcers.&#10;D)increased chance of infection.&#10;E)tissue catabolism (breakdown).

Accepted Answer

Systemic glucocorticoid drugs can cause tissue catabolism, which is the breakdown of muscle and bone tissue. This can lead to muscle weakness, osteoporosis, and an increased risk of fractures. Other potential adverse effects of systemic glucocorticoid drugs include hypertension, aggravation of diabetes mellitus, aggravation of stomach ulcers, and an increased chance of infection. However, tissue catabolism is considered the most important adverse effect from a physical therapy perspective as it can significantly impact a patient's functional abilities and overall quality of life.

Question 5

Prolonged,systemic administration of glucocorticoids can produce:&#10;A)osteoporosis.&#10;B)muscle wasting.&#10;C)hypertension.&#10;D)suppression of the adrenal gland.&#10;E)all of the above

Accepted Answer

Prolonged, systemic administration of glucocorticoids can lead to osteoporosis due to decreased bone formation and increased bone resorption, muscle wasting due to protein breakdown and decreased protein synthesis, hypertension due to increased sodium retention, and suppression of the adrenal gland due to negative feedback on the hypothalamic-pituitary-adrenal axis. Therefore, all of the above choices are correct.

Question 6

Mineralocorticoids such as aldosterone act on the kidneys to:&#10;A)increase sodium excretion.&#10;B)increase water excretion.&#10;C)increase potassium reabsorption.&#10;D)all of the above&#10;E)none of the above

Accepted Answer

Mineralocorticoids like aldosterone increase sodium reabsorption and potassium excretion, not the options listed.

Question 7

Drugs with mineralocorticoidlike activity (aldosterone agonists)are typically administered:&#10;A)to treat hypertension.&#10;B)to treat inflammation.&#10;C)as replacement therapy in patients with low renin-angiotensin system activity.&#10;D)as replacement therapy whenever the natural production of mineralocorticoids is impaired.&#10;E)all of the above

Accepted Answer

Mineralocorticoid agonists are used as replacement therapy when the body's natural production of mineralocorticoids, like aldosterone, is impaired, such as in Addison's disease.

Question 8

Cortisol and other glucocorticoids exert a paradoxical or contradictory effect on glucose metabolism because they _____ circulating levels of glucose at the same time that they ______ glycogen storage in the liver.

A)increase;increase
B)increase;decrease
C)decrease;decrease
D)decrease;increase
E)none of the above;glucocorticoids do not affect glucose metabolism

Accepted Answer

Cortisol and other glucocorticoids increase circulating levels of glucose by promoting gluconeogenesis and decreasing glucose uptake in tissues, while simultaneously increasing glycogen storage in the liver by stimulating glycogen synthase.

Question 9

Mineralocorticoid antagonists such as spironolactone (Aldactone)and eplerenone (Inspra)are used primarily:&#10;A)as diuretics in treating hypertension and heart failure.&#10;B)as anti-inflammatory agents in treating rheumatoid arthritis.&#10;C)as immunosuppressants in treating rheumatoid arthritis.&#10;D)as replacement therapy for people with adrenocortical insufficiency (Addison disease).&#10;E)none of the above

Accepted Answer

Mineralocorticoid antagonists are primarily used as diuretics in treating hypertension and heart failure. They work by blocking the action of aldosterone, a hormone that causes the kidneys to retain sodium and water. By blocking this hormone, these drugs promote the excretion of sodium and water, leading to a reduction in blood volume and therefore blood pressure. While they may have some anti-inflammatory effects, they are not primarily used as such, and they are not used as immunosuppressants. Additionally, while they may be used in some cases of adrenocortical insufficiency, they are not typically used as replacement therapy for this condition.

Question 10

Glucocorticoids exert their anti-inflammatory effects by:&#10;A)increasing the transcription of proteins that decrease inflammation.&#10;B)decreasing the transcription of inflammatory cytokines,enzymes,and other inflammatory proteins.&#10;C)decreasing vascular permeability and helping to control swelling and erythema at the site of inflammation.&#10;D)all of the above&#10;E)A and B

Accepted Answer

Glucocorticoids exert their anti-inflammatory effects by increasing the transcription of proteins that decrease inflammation, decreasing the transcription of inflammatory cytokines, enzymes, and other inflammatory proteins, as well as decreasing vascular permeability and helping to control swelling and erythema at the site of inflammation. Therefore, the correct choice is D, all of the above.

Question 11

In humans,the primary mineralocorticoid produced by the adrenal cortex is _____,and the primary glucocorticoid produced by the adrenal cortex is _______.&#10;A)progesterone;testosterone&#10;B)testosterone;estrogen&#10;C)estrogen;aldosterone&#10;D)aldosterone;cortisol&#10;E)cortisol;progesterone

Accepted Answer

The answer of In humans,the primary mineralocorticoid produced by the...

Deck 29: Adrenocorticosteroids