Wayground logo

Free Printable Worksheets

Font size

S
M
L
XL
Worksheets

Pharm - Endocrine

Total questions: 159

Worksheet time: 2hrs 32mins

Name
Class
Date
1.

Which medication would be appropriate for a pregnant women in her first trimester? [Jett lecture]

a)

PTU

b)

MMI

c)

RAI

2.

Which statement is true about medications used to treat hyperthyroidism? [Jett lecture]

a)

PTU is 10 times more potent than MMI

b)

RAI is not likely to induce hypothyroidism

c)

MMI has a potential to cause hepatotoxicity

3.

Which is a good treatment option to inhibit signs and symptoms of hyperthyroidism such as anxiety and tremor? [Jett lecture] ***

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

4.

Which is true regarding treatment options for hypothyroidism? [Jett lecture]

a)

Levothyroxine (Synthroid) should be taken with meals

b)

Liothyronine (Cytomel) is often used alone

c)

Natural Thyroid Hormone (Armour Thyroid) is not recommended first line for hypothyroidism

5.

Which medication used for hypothyroidism is considered the drug of choice for pregnancy? [Jett lecture]

a)

Natural Thyroid Hormone (Armour thyroid)

b)

Liothyronine (Cytomel)

c)

Levothyroxine (Synthroid)

d)

Beta-Blockers (Propranolol)

6.

Hyperthyroidism goals of therapy

a)

Minimize symptoms and long-term complications

b)

Eliminate excess hormone

c)

Restore normal hormone concentrations

d)

Prevent neurologic deficits in newborns and children

7.

First line therapy in children, adolescents, and pregnancy

a)

Antithyroid medications

b)

Surgery

c)

Beta-blockers

8.

Thioamides

a)

Propylthiouracil (PTU)

b)

Methimazole (MMI)

c)

Radioactive iodine (RAI)

d)

Propranolol

9.

Thioamides

a)

Levels at/near baseline within 4-8 weeks, should begin taper at this time

b)

Levels at/near baseline within 12-24 months, should begin taper at this time

c)

Continuation of therapy for 12-24 months to induce remission

d)

Continuation of therapy for 4-8 weeks to induce remission

e)

Remission rates average 40-50%, follow up every 6-12 months after remission

10.

DOC in 1st trimester of pregnancy ***

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

11.

Administer at the same time each day ***

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

12.

DOC in neonates, children, and 2nd and 3rd trimesters of pregnancy ***

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

13.

_____ 10 times more potent than ____

a)

PTU ; MMI

b)

MMI ; PTU

14.

Minor adverse effects of Thioamide

a)

Benign transient leukopenia; WBC <4000/mm3

b)

GI intolerance

c)

Rash

d)

Fever

e)

Arthralgias

15.

Major adverse effects of Thioamide

a)

Agranulocytosis

b)

Hepatotoxicity

c)

Nephrotoxicity

d)

Anaphylaxis

16.

Boxed Warning: Severe liver injury and acute liver failure resulting in death and transplantation

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

17.

MOA: Disrupts hormone synthesis -- Destroys overactive follicular cells

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

18.

Maximal effect in 3-6 months

-60% of patient become euthyroid

-May repeat in 6 months if hyperthyroid

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

19.

Contraindicated in pregnancy

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

20.

Permanent hypothyroidism almost inevitable

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

21.

Relieve symptoms (palpitations, tremor, anxiety, heat intolerance) ***

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

22.

MOA: Blocks the response to B-adrenergic stimulation -- Partially prevents conversion of T4 to T3

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

23.

Place in therapy ***

-Adjunct to anti-thyroid medications

-Thyroid storm

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

24.

AE: N/V, bradycardia, light-headedness

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

25.

Caution in asthma/COPD (vasoconstriction in lungs) and diabetes (masks signs of hypoglycemia)

a)

PTU

b)

MMI

c)

RAI

d)

Propranolol

26.

Most invasive option, but also effective

a)

Antithyroid medications

b)

Surgery

c)

Beta-blockers

27.

-Option for patients who refuse RAI

-Consider for patients with a large thyroid gland or who have failed to obtain remission on antithyroid medications

a)

Antithyroid medications

b)

Surgery

c)

Beta-blockers

28.

Preparation for thyroidectomy:

a)

Thioamide 6-8 weeks prior to induce euthyroid state

b)

Iodides for 10-14 days to reduce vascularity

c)

Propranolol for several weeks pre-operatively and 7-10 days post-operatively

d)

Thioamide 10-14 days prior to induce euthyroid state

e)

Iodides for 6-8 weeks to reduce vascularity

29.

Complications of surgery:

a)

Hypothyroidism in 49% of patients

b)

Vocal cord abnormalities

c)

Increased rate of stillbirths

d)

Lower psychological scores in infants

30.

Thyroid storm goals of treatment

a)

Minimize symptoms and long-term complications

b)

Eliminate excess hormone

c)

Supportive measures

d)

Inhibit thyroid hormone synthesis and release

31.

Thyroid storm treatment

a)

High doses of PTU and iodide

b)

Beta-blocker

c)

Corticosteroids

d)

Low doses of PTU and iodide

e)

NSAIDS or aspirin

32.

NO NSAIDS or aspirin in thryoid storm treatment

a)

True

b)

False

33.

Hypothyroidism: Goals of therapy

a)

Restore normal hormone concentrations

b)

Provide symptomatic relief

c)

Prevent neurologic deficits in newborns and children

d)

Reverse biochemical abnormalities of hypothyroidism

e)

Eliminate excess hormone

34.

Hyperthyroidism: Treatment options

a)

Antithyroid medications

b)

Surgery

c)

Beta blockers

d)

Synthetic hormone

e)

Natural thyroid hormone

35.

Hypothyroidism: Treatment options

a)

Antithyroid medications

b)

Surgery

c)

Beta blockers

d)

Synthetic hormone

e)

Natural thyroid hormone

36.

Synthetic Hormones

a)

Liothyronine (Cytomel, Triostat)

b)

Levothyroxine/liothyronine (Liotrix)

c)

Levothyroxine (Synthroid, Levoxyl)

d)

Dessicated thyroid (Armour Thyroid, Nature-Throid)

37.

Natural Thyroid Hormone

a)

Liothyronine (Cytomel, Triostat)

b)

Levothyroxine/liothyronine (Liotrix)

c)

Levothyroxine (Synthroid, Levoxyl)

d)

Dessicated thyroid (Armour Thyroid, Nature-Throid)

38.

Synthetic T3 hormone, usually in combination with synthetic T4

a)

Liothyronine (Cytomel, Triostat)

b)

Levothyroxine/liothyronine (Liotrix)

c)

Levothyroxine (Synthroid, Levoxyl)

d)

Dessicated thyroid (Armour Thyroid, Nature-Throid)

39.

Higher incidence of cardiac side effects

a)

Liothyronine (Cytomel, Triostat)

b)

Levothyroxine/liothyronine (Liotrix)

c)

Levothyroxine (Synthroid, Levoxyl)

d)

Dessicated thyroid (Armour Thyroid, Nature-Throid)

40.

Combination synthetic T4 / T3

a)

Liothyronine (Cytomel, Triostat)

b)

Levothyroxine/liothyronine (Liotrix)

c)

Levothyroxine (Synthroid, Levoxyl)

d)

Dessicated thyroid (Armour Thyroid, Nature-Throid)

41.

Synthetic T4 hormone

a)

Liothyronine (Cytomel, Triostat)

b)

Levothyroxine/liothyronine (Liotrix)

c)

Levothyroxine (Synthroid, Levoxyl)

d)

Dessicated thyroid (Armour Thyroid, Nature-Throid)

42.

Drug of choice for thyroid hormone replacement

a)

Liothyronine (Cytomel, Triostat)

b)

Levothyroxine/liothyronine (Liotrix)

c)

Levothyroxine (Synthroid, Levoxyl)

d)

Dessicated thyroid (Armour Thyroid, Nature-Throid)

43.

Levothyroxine (Synthroid, Levoxyl)

a)

Take on an empty stomach

b)

Take with meals

44.

Levothyroxine (Synthroid, Levoxyl): adverse effects (related to excessive dosing)

a)

Restlessness

b)

Insomnia

c)

Osteoporosis

d)

Tachycardia

e)

Bradycardia

45.

Not 1st line

a)

Liothyronine (Cytomel, Triostat)

b)

Levothyroxine/liothyronine (Liotrix)

c)

Levothyroxine (Synthroid, Levoxyl)

d)

Dessicated thyroid (Armour Thyroid, Nature-Throid)

46.

Derived from hog, beef, or sheep thyroid

a)

Liothyronine (Cytomel, Triostat)

b)

Levothyroxine/liothyronine (Liotrix)

c)

Levothyroxine (Synthroid, Levoxyl)

d)

Dessicated thyroid (Armour Thyroid, Nature-Throid)

47.

Complications of hypothyroidism and pregnancy

a)

Hypothyroidism in 49% of patients

b)

Vocal cord abnormalities

c)

Increased rate of stillbirths

d)

Lower psychological scores in infants

48.

Hypothyroidism and Pregnancy: Thyroid hormone necessary for fetal growth

a)

True

b)

False

49.

Hypothyroidism and Pregnancy : _______ is drug of choice

a)

Liothyronine (Cytomel, Triostat)

b)

Levothyroxine/liothyronine (Liotrix)

c)

Levothyroxine (Synthroid, Levoxyl)

d)

Dessicated thyroid (Armour Thyroid, Nature-Throid)

50.

Myxedema Coma initial treatment

a)

IV levothyroxine bolus

b)

IV liothyronine bolus

c)

IV levothyroxine/liothyronine bolus

d)

IV armour thyroid bolus

51.

Myxedema Coma treatment (after inital treatment)

a)

Maintenance doses of IV (levothryoxine bolus) until patient stable

b)

IV hydrocortisone

c)

Supportive care

d)

Beta blocker

e)

High doses of PTU and iodide

52.

Growth Hormone is controlled by two hormones from the

a)

hypothalamus

b)

pituitary

c)

adrenal

d)

thyroid

53.

Increases growth hormone secretion.

a)

Growth hormone-releasing hormone (GHRH)

b)

Somatostatin

54.

Inhibits growth hormone

a)

Growth hormone-releasing hormone (GHRH)

b)

Somatostatin

55.

Growth Hormone: hormone of the _____ pituitary

a)

anterior

b)

posterior

56.

Somatotrophs are cells of the ______ pituitary that secrete somatotropin (or GH)

a)

anterior

b)

posterior

57.

IGF-1 effects in muscle

a)

anabolic effects

b)

catabolic effects

c)

increase in muscle mass

d)

decrease in muscle mass

58.

IGF-1 effects in adipose cells

a)

anabolic effects

b)

catabolic effects

c)

reduction in adiposity

d)

production in adiposity

59.

Lack of growth hormone results in

a)

dwarfism

b)

acromegaly

c)

gigantism

60.

Excess growth hormone in children results in __________ (because bone growth plates have not fused)

a)

dwarfism

b)

acromegaly

c)

gigantism

61.

Excess growth hormone in adults results in ________ -- thickening of the bones and soft tissues.

a)

dwarfism

b)

acromegaly

c)

gigantism

62.

has a half-life of approximately 20 minutes and is predominantly cleared by the liver.

a)

Circulating endogenous GH

b)

Recombinant human GH (rhGH)

63.

is administered subcutaneously 6–7 times per week. Peak levels occur in 2–4 hours and active blood levels persist for approximately 36 hours.

a)

Circulating endogenous GH

b)

Recombinant human GH (rhGH)

64.

is rapidly cleared from the circulation, with a half-life of 1–3 minutes. The kidney appears to play an important role in its metabolism and excretion.

a)

Somatostatin

b)

Octerotide

65.

The plasma elimination half-life is about 80 minutes

a)

Somatostatin

b)

Octerotide

66.

Which of the following is indicated (first-line) for growth failure in pediatric patients with Turner syndrome? [Riggs quiz]

a)

Octreotide

b)

Pegvisomant

c)

Mecasermin

d)

Somatotropin

67.

Which of the following is a growth hormone antagonist? [Riggs quiz]

a)

Pegvisomant

b)

Octreotide

c)

Somatotropin

d)

Somatostatin

68.

Somatropes are found in which endocrine gland? [Riggs quiz]

a)

Pituitary

b)

Adrenal Glands

c)

Thyroid

d)

Hypothalamus

69.

Treatment with recombinant growth hormone failes to elevate IGF-1 in a pediatric patient with idiopathic short stature. What drug is indicated? [Riggs quiz]

a)

Somatotropin

b)

Mecasermin

c)

Octreotide

d)

Pegvisomant

70.

Which of the following would be the best drug to stop growth hormone secretion from a pituitary adenoma in a 27-year-old female? [Riggs quiz]

a)

Octreotide

b)

Pegvisomant

c)

Stomatotropin

d)

Mecasermin

71.

Recombinant Growth Hormone

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

72.

Recombinant IGF

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

73.

Somatostatin analog

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

74.

GH antagonist

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

75.

MOA: Has two GH receptor binding sites --> One site on the drug has increased affinity to the GH receptor and One site has a mutation that blocks receptor dimerization and generation of the phosphorylating signal.

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

76.

Indications: acromegaly

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

77.

MOA: “acts like” endogenous somatostatin

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

78.

Adverse effects: increases in liver enzymes without liver failure have been reported; does not inhibit GH secretion and may lead to increased GH levels and possible adenoma growth.

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

79.

Indicated in Cushing disease and acromegaly

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

80.

Why is Pasireotide indicated in Cushing disease?

a)

Inhibits ACTH

b)

Inhibits GH and IGF-1

81.

Why is Pasireotide indicated in acromegaly?

a)

Inhibits ACTH

b)

Inhibits GH and IGF-1

82.

Indications: reduces symptoms caused by a variety of hormone-secreting tumors: acromegaly, carcinoid syndrome, gastrinoma, glucagonoma, insulinoma, VIPoma, and ACTH-secreting tumor

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

83.

Octerotide other uses include:

a)

secretory diarrhea

b)

HIV associated

c)

portal hypertension

d)

useful for acute control of esophageal varices

e)

patients with short bowel syndrome who are dependent on total parenteral nutrition (TPN)

84.

Adverse Effects: Nausea, vomiting, abdominal cramps, flatulence, and steatorrhea with bulky bowel movements.

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

85.

Metabolism: extensively hepatic

a)

Somatostatin

b)

Octerotide

86.

Mecasermin adverse side effect ***

a)

hypoglycemia (IGF-1 has the opposite effect on blood glucose than GH)

b)

hyperglycemia (IGF-1 has the same effect on blood glucose than GH)

c)

Patients are instructed to consume a carbohydrate meal or snack 20 min before or after administration.

d)

Patients are instructed to have an empty stomach before administration.

87.

Indicated in growth hormone deficiency that does not respond to somatotropin

a)

Mecasermin

b)

Octerotide

c)

Pasireotide

d)

Pegvisomant

88.

Treatment is contraindicated in a patient with a known active malignancy.

a)

Somatotropin

b)

Mecasermin

c)

Octerotide

d)

Pasireotide

e)

Pegvisomant

89.

Somatropin adverse reactions occur less frequently in ______ vs ______

a)

children ; adults

b)

adults ; children

90.

Growth Hormone other uses include:

a)

useful for acute control of esophageal varices

b)

builds muscle mass and endurance (banned by the International Olympic Committee)

c)

dairy cattle to increase milk production

d)

wasting in patients with AIDS

e)

patients with short bowel syndrome who are dependent on total parenteral nutrition (TPN)

91.

Somatropin Indications

a)

Idiopathic Short Stature

b)

Prader-Willi syndrome

c)

Turner syndrome

d)

Noonan syndrome

e)

Marfan syndrome

92.

Somatotropin Indications in Children

a)

Inadequate endogenous GH secretion

b)

Growth failure caused by disorder other than GH deficiency

c)

Hormone-secreting tumors

d)

Growth failure due to severe IGF-1 deficiency that is not responsive to exogenous GH

93.

Somatotropin pharmacodynamics

a)

GH binds cell surface receptors & activates signaling cascades

b)

Has two GH receptor binding sites

94.

Somatotropin

a)

Humatrope

b)

Genotropin

c)

Nutropin

d)

Mecasermin

e)

Pegvisomant

95.

Calcitonin helps ***

a)

DECREASE calcium

b)

INCREASE calcium

96.

PTH helps ***

a)

DECREASE calcium

b)

INCREASE calcium

97.

____ releases calcitonin

a)

thyroid

b)

parathyroid

c)

adrenal

d)

pituitary

98.

Osteoporotic Fractures --> Principal sites for fractures: ***

a)

hip

b)

wrist

c)

spine

d)

pelvis

e)

sacrum

99.

_____ fractures account for ~75% of fracture costs and are associated with greatest morbidity

a)

hip

b)

wrist

c)

spine

100.

gold standard for diagnosis (osteoporosis) ***

a)

DEXA scan

b)

FRAX tool

101.

amount of bone compared with a young adult of same gender with peak bone mass → used for diagnosis

a)

T-score

b)

Z-score

102.

amount of bone compared with people in same age group or same size and gender → not used for diagnosis *adjusted for race/ethnicity

a)

T-score

b)

Z-score

103.

T-score: -1 and above ***

a)

Normal

b)

Osteopenia

c)

Osteoporosis

d)

Severe Osteoporosis

104.

T-score: -1 to -2.5 ***

a)

Normal

b)

Osteopenia

c)

Osteoporosis

d)

Severe Osteoporosis

105.

T-score: Less than -2.5 ***

a)

Normal

b)

Osteopenia

c)

Osteoporosis

d)

Severe Osteoporosis

106.

T-score: Less than -2.5 w/ fractures ***

a)

Normal

b)

Osteopenia

c)

Osteoporosis

d)

Severe Osteoporosis

107.

Inhibit bone resorption ***

a)

Antiresorptive

b)

Anabolic

108.

Stimulate Bone Formation ***

a)

Antiresorptive

b)

Anabolic

109.

Antiresorptive ***

a)

Calcium & Vitamin D

b)

Bisphosphonates

c)

Recombinant Parathyroid Hormone

d)

PTH-Related Protein

e)

Sclerostin Inhibitor

110.

Anabolic ***

a)

Calcium & Vitamin D

b)

Bisphosphonates

c)

Recombinant Parathyroid Hormone

d)

PTH-Related Protein

e)

Sclerostin Inhibitor

111.

Antiresportive ***

a)

RANKL Inhibitor

b)

Selective Estrogen-Receptor Modulators

c)

Tissue-Selective Estrogen Complex

d)

Calcitonin

e)

Estrogen/Hormone Therapy

112.

Carbonate ***

a)

Elemental calcium: 40%

b)

Elemental calcium: 20%

113.

Citrate ***

a)

Elemental calcium: 40%

b)

Elemental calcium: 20%

114.

Calcium causes _______, carbonate is the worst for it. ***

a)

constipation

b)

diarrhea

115.

When to consider prescription therapy?

a)

Osteoporosis

b)

Osteopenia

c)

High risk

116.

Alendronate (Fosamax®, Fosamax® plus D, Binosto®) administration ***

a)

First thing in the morning with 8 oz water, avoid food/drink and remain upright for 30 minutes

b)

First thing in morning with 8 oz water, avoid food/drink and remain upright for 60 minutes

c)

Take immediately after breakfast with 4 oz water, avoid food/drink and remain upright for 30 minutes

117.

will see this drug in two different settings: osteoporosis and breast cancer prevention ***

a)

Raloxifene

b)

Denosumab

c)

Zolendronic Acid

d)

Duavee

118.

MOA: selectively binds to estrogen receptors (SERM)

a)

Raloxifene

b)

Duavee

c)

Denosumab

119.

MOA: tissue-selective estrogen complex that is estrogen therapy plus estrogen agonist/antagonist

a)

Raloxifene

b)

Duavee

c)

Denosumab

120.

MOA: fully human monoclonal antibody that inhibits RANKL and therefore prevents maturation of osteoclasts

a)

Raloxifene

b)

Duavee

c)

Denosumab

121.

MOA: decrease osteoclast maturation and lifespan therefore decreasing the rate of bone resorption

a)

Bisphosphonates

b)

Calcitonin

c)

Estrogen/Hormone Therapy

122.

MOA: reduces osteoclasts and increases osteoblast activity

a)

Bisphosphonates

b)

Calcitonin

c)

Estrogen/Hormone Therapy

123.

MOA: bind to osteoblasts to increase activity and decrease osteoclast activity

a)

Bisphosphonates

b)

Calcitonin

c)

Estrogen/Hormone Therapy

124.

Calcitonin dosage ***

a)

Nasal Spray

b)

SQ

c)

IM

d)

IV

125.

no longer in the guidelines for treatment of osteoporosis ***

a)

Bisphosphonates

b)

Calcitonin

c)

Estrogen/Hormone Therapy

126.

MOA: recombinant human parathyroid hormone that increases bone formation, bone remodeling rate, and osteoblast number/activity

a)

Teriparatide

b)

Abaloparatide

c)

Romosozumab

127.

MOA: human parathyroid hormone analog that stimulates osteoblast function and increased bone mass

a)

Teriparatide

b)

Abaloparatide

c)

Romosozumab

128.

MOA: sclerostin inhibitor, a regulatory factor in bone metabolism that inhibits signaling pathways resulting in bone growth

a)

Teriparatide

b)

Abaloparatide

c)

Romosozumab

129.

Treatment for Anaphylaxis

a)

Epinephrine

b)

Spironolactone

c)

Fludrocortisone (Florinef)

d)

Ketoconazole (Nisoral)

130.

Pheochromocytoma treatment

a)

Laparoscopic surgical excision of the tumor (with adjunctive radiopharmaceutical agents or chemotherapy)

b)

Alpha- and beta-adrenergic blockers for hypertension

c)

surgery for adenoma

d)

administration of aldosterone receptor antagonists (spironolactone)

131.

Hypoaldosteronism treatment

a)

Epinephrine

b)

Spironolactone

c)

Fludrocortisone (Florinef)

d)

Ketoconazole (Nisoral)

132.

MOA: Stimulates alpha-, beta1-, and beta2-adrenergic receptors

a)

Epinephrine

b)

Spironolactone

c)

Fludrocortisone (Florinef)

d)

Ketoconazole (Nisoral)

133.

Epinephrine results in:

a)

relaxation of bronchial smooth muscle

b)

cardiac stimulation

c)

cardiac depression

d)

constriction of bronchial smooth muscle

134.

Hyperaldosteronism clinical manifestations

a)

hypertension

b)

hypotension

c)

hypoalkemia (renal potassium wasting)

d)

hyperalkemia

e)

neuromuscular manifestations

135.

Hyperaldosternoism treatment

a)

Laparoscopic surgical excision of the tumor (with adjunctive radiopharmaceutical agents or chemotherapy)

b)

surgery for adenoma

c)

administration of aldosterone receptor antagonists (spironolactone)

d)

management of hypertension and hypokalemia

136.

Hyperaldosternoism evaluation ***

a)

serum sodium & serum potassium is normal or elevated

b)

serum sodium & serum potassium is suppressed

c)

urinary potassium is elevated

d)

urinary potassium is suppressed

137.

ORAL SALT LOADING results

a)

If aldosterone is still elevated, then primary aldosteronism

b)

If aldosterone decreases, then negative test

c)

If aldosterone is still elevated, then negative test

d)

If aldosterone decreases, then primary aldosteronism

138.

FLUDROCORTISONE SUPPRESSION TEST results

a)

Negative: aldosterone levels lower due to neg feedback mech: no hyperaldosteronism

b)

Positive: aldosterone remains high; indicates hyperaldosteronism

c)

Negative: aldosterone remains high; indicates hyperaldosteronism

d)

Positive: aldosterone levels lower due to neg feedback mech: no hyperaldosteronism

139.

(potassium sparing diuretic) with the goal of excreting more sodium, retaining potassium and lowering blood pressure

a)

Epinephrine

b)

Spironolactone

c)

Fludrocortisone (Florinef)

d)

Ketoconazole (Nisoral)

140.

Potent mineralocorticoid and potent glucocorticoid

a)

Epinephrine

b)

Spironolactone

c)

Fludrocortisone (Florinef)

d)

Ketoconazole (Nisoral)

141.

Usually administered in conjunction with a glucocorticoid to achieve total replacement therapy in primary adrenocortical insufficiency. (Addison’s disease, congenital adrenal hyperplasia)

a)

Epinephrine

b)

Spironolactone

c)

Fludrocortisone (Florinef)

d)

Ketoconazole (Nisoral)

142.

Adverses Effects of long-term steroid therapy of mineralocorticoids

a)

sodium and water retention

b)

loss of potassium

c)

gain of potassium

143.

Adrenal enzyme inhibitor

a)

Epinephrine

b)

Spironolactone

c)

Fludrocortisone (Florinef)

d)

Ketoconazole (Nisoral)

144.

Hypercortisolism of Cushing’s syndrome

a)

is primarily treated surgically

b)

requires medical therapy

145.

Hypercortisolism of Cushing’s syndrome: When surgery is delayed, contraindicated, or unsuccessful, medical therapy is required

a)

Epinephrine

b)

Spironolactone

c)

Fludrocortisone (Florinef)

d)

Ketoconazole (Nisoral)

146.

Drug interactions with glucocorticoids ***

a)

Insulin

b)

Oral hypoglycemics

c)

Beta blockers

d)

Warfarin

147.

Glucocorticoids: Clinical Indications for replacement therapy

a)

adrenal cortical insufficiency

b)

multiple sclerosis

c)

inflammatory disorders

d)

management of leukemia and lymphomas

e)

autoimmune disorders

148.

in two or three divided doses at the lowest dose that relieves symptoms *natural, not synthetic

a)

Hydrocortisone

b)

Prednisone

c)

Dexamethasone

149.

daily; provide smoother physiological effect; may be useful in noncompliant patients

a)

Hydrocortisone

b)

Prednisone

c)

Dexamethasone

150.

Slight alterations in structure results in higher affinity for the GR compare to naturally occurring steroids. Longer duration of action.

a)

Hydrocortisone

b)

Prednisone

c)

Dexamethasone

151.

Hydrocortisone

a)

Natural, short-acting glucocorticoids

b)

Synthetic/Long-acting glucocorticoids

c)

Duration of action (hours): 24-36

d)

Duration of action (hours): 48-72

e)

Duration of action (hours): 12-24

152.

Prednisone

a)

Natural, short-acting glucocorticoids

b)

Synthetic/Long-acting glucocorticoids

c)

Synthetic intermediate-acting

d)

Duration of action (hours): 24-36

e)

Duration of action (hours): 48-72

153.

Dexamethasone

a)

Natural, short-acting glucocorticoids

b)

Synthetic/Long-acting glucocorticoids

c)

Synthetic intermediate-acting

d)

Duration of action (hours): 24-36

e)

Duration of action (hours): 48-72

154.

Adverse effects of long-term steroid therapy of glucocorticoids

a)

Increased gluconeogenesis

b)

Increased protein catabolism

c)

Decreased gluconeogenesis

d)

Decreased protein catabolism

155.

A solution of alternate-day therapy can be used to reduce or eliminate adverse effects from long-term treatment of

a)

steroids

b)

aldosterone-receptor antagonists

c)

adrenal enzyme inhibitor

156.

ACTH Stimulation Test: results for primary adrenal insufficiency

a)

no change in cortisol

b)

rise in cortisol

157.

ACTH Stimulation Test: results for secondary adrenal insufficiency

a)

no change in cortisol

b)

rise in cortisol

158.

Alternate-day therapy: ________ steroid every other day in the morning

a)

short-acting

b)

long-acting

159.

Alternate-day therapy: on the 2nd day the ______ is release from negative feedback

a)

adrenal gland

b)

thyroid

c)

pituitary