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Worksheets

Hypothalamic & Pituitary Medications and Endocrine Disorders

Total questions: 60

Worksheet time: 31mins

Name
Class
Date
1.

Which drug is a recombinant form of human IGF-1 used for children with severe IGF-1 deficiency unresponsive to growth hormone?

a)

Octreotide

b)

Mecasermin

c)

Pegvisomant

d)

Pasireotide

2.

Which agent acts as a GH receptor antagonist used for acromegaly but may increase GH levels?

a)

Somatostatin

b)

Octreotide

c)

Pegvisomant

d)

Mecasermin

3.

Which somatostatin analog has a higher affinity for receptor subtype 5 and provides greater control of acromegaly?

a)

Octreotide

b)

Pasireotide

c)

Lanreotide

d)

Somatostatin

4.

Menotropins (hMG) are purified from:

a)

Placental tissue

b)

Urine of postmenopausal women

c)

Pituitary extract

d)

Human serum

5.

Continuous administration of a GnRH analog results in:

a)

Increased LH and FSH secretion

b)

Decreased LH and FSH secretion

c)

Increased testosterone production

d)

Increased ovulation frequency

6.

Which GnRH analog is commonly administered intranasally for controlled ovarian stimulation?

a)

Leuprolide

b)

Nafarelin

c)

Triptorelin

d)

Histrelin

7.

Which GnRH receptor antagonist is approved for men with advanced prostate cancer?

a)

Ganirelix

b)

Cetrorelix

c)

Degarelix

d)

Gonadorelin

8.

Dopamine normally inhibits prolactin secretion by:

a)

D1 receptor activation

b)

D2 receptor activation

c)

Beta-adrenergic receptor blockade

d)

Increased cAMP production

9.

Which drug is used to treat hyperprolactinemia?

a)

Bromocriptine

b)

Risperidone

c)

Metoclopramide

d)

TRH

10.

Hyperprolactinemia can be induced by:

a)

Dopamine agonists

b)

Dopamine antagonists

c)

Glucocorticoids

d)

Thyroxine

11.

Oxytocin’s uterine contraction is mediated by which second messenger system?

a)

Adenylyl cyclase–cAMP

b)

Phosphoinositide–Ca²⁺ pathway

c)

NO–cGMP

d)

MAP-kinase

12.

Which agent is an oxytocin receptor antagonist used outside the U.S. for preterm labor?

a)

Vasopressin

b)

Atosiban

c)

Desmopressin

d)

Conivaptan

13.

Desmopressin differs from vasopressin because it:

a)

Has shorter duration

b)

Causes vasoconstriction

c)

Is selective for V2 receptors

d)

Raises blood pressure

14.

Conivaptan and tolvaptan are approved for treatment of:

a)

Diabetes insipidus

b)

Hyponatremia

c)

Hypotension

d)

Pulseless arrest

15.

What life-threatening condition can occur with rapid sodium correction using tolvaptan?

a)

Rhabdomyolysis

b)

Osmotic demyelination syndrome

c)

Addisonian crisis

d)

Myxedema coma

16.

Menotropins (hMG) contain which combination of hormones?

a)

LH + FSH

b)

GH + ACTH

c)

TSH + LH

d)

FSH + Prolactin

17.

Continuous administration of GnRH analogs causes:

a)

Increased FSH and LH

b)

Decreased FSH and LH

c)

Increased estrogen levels

d)

Pituitary stimulation

18.

Leuprolide is classified as a:

a)

GnRH antagonist

b)

GnRH analog

c)

Dopamine agonist

d)

Somatostatin analog

19.

Ganirelix and cetrorelix are used during controlled ovarian stimulation to:

a)

Stimulate follicle growth

b)

Prevent premature LH surge

c)

Increase progesterone

d)

Induce ovulation

20.

Which receptor type mediates dopamine’s inhibitory effect on prolactin?

a)

D1

b)

D2

c)

Beta-1

d)

Alpha-2

21.

Which drug can increase prolactin secretion?

a)

Bromocriptine

b)

Risperidone

c)

Cabergoline

d)

Dopamine

22.

Which dopamine agonist is used to treat hyperprolactinemia?

a)

Cabergoline

b)

Risperidone

c)

Metoclopramide

d)

Octreotide

23.

Oxytocin acts through which intracellular signaling pathway?

a)

cAMP

b)

IP₃ / Ca²⁺

c)

cGMP

d)

JAK-STAT

24.

Vasopressin V₁a receptors primarily cause:

a)

Vasodilation

b)

Vasoconstriction

c)

Natriuresis

d)

Increased heart rate

25.

Vasopressin V₂ receptors are responsible for:

a)

Uterine contraction

b)

Water reabsorption

c)

Glycogen breakdown

d)

Vasoconstriction

26.

Desmopressin differs from vasopressin because it:

a)

Is shorter-acting

b)

Causes less vasoconstriction

c)

Has weaker antidiuretic effect

d)

Acts mainly on V₁ receptors

27.

Which drug is FDA-approved for hyponatremia?

a)

Desmopressin

b)

Conivaptan

c)

Vasopressin

d)

Atosiban

28.

Which feature distinguishes neonatal growth from postnatal growth regarding GH dependence?

a)

Both require GH

b)

Neither require GH

c)

Prenatal growth is GH-independent; postnatal growth becomes GH-dependent

d)

Only prenatal growth is GH-dependent

29.

Which recombinant FSH preparations have shorter half-lives than urinary menotropins?

a)

Menotropins

b)

Follitropin alfa and Follitropin beta

c)

Leuprolide and Goserelin

d)

Degarelix and Abarelix

30.

Which condition involves premature activation of secondary sexual characteristics?

a)

Acromegaly

b)

Central precocious puberty

c)

Hypogonadotropic hypogonadism

d)

Hyperthyroidism

31.

Which symptom suggests prolactin deficiency?

a)

Galactorrhea

b)

Failure to lactate

c)

Amenorrhea

d)

Erectile dysfunction

32.

Which medications can cause hyperprolactinemia?

a)

Metoclopramide

b)

Cabergoline

c)

Atosiban

d)

Leuprolide

33.

In addition to diabetes insipidus, desmopressin is indicated for:

a)

Cushing’s syndrome

b)

Nocturnal enuresis

c)

Acromegaly

d)

Ovarian hyperstimulation

34.

Vasopressin is sometimes administered instead of epinephrine for:

a)

Asthma attack

b)

Anaphylaxis

c)

Pulseless cardiac arrest

d)

Septic shock with hypertension

35.

Which oxytocin-related drug is not FDA-approved in the U.S.?

a)

Atosiban

b)

Conivaptan

c)

Desmopressin

d)

Vasopressin

36.

In men, LH primarily stimulates:

a)

Spermatogenesis

b)

Testosterone synthesis

c)

Inhibin B secretion

d)

Estrogen production

37.

Which GnRH analog is administered via a portable IV pump every 90 minutes to treat male infertility?

a)

Goserelin

b)

Gonadorelin

c)

Nafarelin

d)

Histrelin

38.

Which condition benefits from GnRH agonist suppression therapy?

a)

Acromegaly

b)

Endometriosis

c)

Diabetes insipidus

d)

Gigantism

39.

Which symptom best reflects hyperprolactinemia in premenopausal women?

a)

Polyuria

b)

Galactorrhea

c)

Tachycardia

d)

Thyromegaly

40.

Which hormone induces milk ejection (let-down) reflex from mammary alveoli?

a)

Prolactin

b)

Oxytocin

c)

FSH

d)

LH

41.

Which patient population should receive vasopressin cautiously due to risk of coronary ischemia?

a)

Pregnant women

b)

Patients with CAD

c)

Patients with diabetes insipidus

d)

Adolescents with gigantism

42.

Somatostatin inhibits release of which of the following hormones?

a)

GH

b)

TSH

c)

Glucagon

d)

Gastrin

e)

Insulin

43.

The majority of cases of ACTH-dependent Cushing syndrome are caused by

a)

Adrenal carcinoma

b)

Primary pigmented nodular adrenal disease

c)

Adrenal adenoma

d)

Pituitary adenoma

44.

In an adult female patient with classic Cushing disease (caused by an adrenal adenoma), the preferred treatment is:

a)

Mitotane 3 g three times a day

b)

Pasireotide 0.6 mg twice daily

c)

Resection of the adrenal tumor

d)

Mifepristone 300 mg once daily

45.

Which of the following drugs has been associated with an increased risk of serious hepatotoxicity?

a)
  1. Cabergoline

b)
  1. Metyrapone

c)
  1. Ketoconazole

d)
  1. Pasireotide

46.

The majority of cases of primary aldosteronism are caused by:

a)

Aldosterone-producing adenomas

b)

Bilateral adrenal hyperplasia

c)

Unilateral adrenal hyperplasia

d)

Familial hyperaldosteronism (FH) type 1

47.

The treatment of choice for bilateral adrenal hyperplasia-dependent aldosteronism is:

a)

Spironolactone

b)

Mifepristone

c)

Angiotensin receptor blockers

d)

Partial adrenalectomy

48.

Which of the following signs or symptoms is seen in both primary and secondary adrenal insufficiency?

a)
  1. Hyperpigmentation

b)
  1. Normal aldosterone secretion

c)
  1. Normal response to the rapid ACTH stimulation test

d)
  1. Weakness

49.

The agent of choice for the immediate treatment of acute adrenal insufficiency is:

a)

5% dextrose in normal saline IV

b)

Prednisone 5 mg by mouth

c)

Hydrocortisone 100 mg IV

d)

Fludrocortisone 0.1 mg by mouth

50.

Congenital adrenal hyperplasia (CAH) associated with deficiency in 21-hydroxylase can lead to selective hypoaldosteronism manifesting hyponatremia or hyperkalemia. Which of the following treatment options is preferred for selective hypoaldosteronism?

a)
  1. Mitotane

b)
  1. Spironolactone

c)
  1. Prednisolone

d)
  1. Fludrocortisone

51.

Which of the following pharmacologic agents would be first line for treatment of hirsutism in women due to adrenal androgen excess?

a)
  1. Dexamethasone

b)
  1. Ethinyl estradiol and norethindrone

c)
  1. Osilodrostat

d)
  1. Gonadotropin-releasing hormone

52.

Adult patients who will be taking long-term glucocorticoids should be warned about which of the following?

a)
  1. Weight loss and hypersomnia early in therapy

b)
  1. Osteoporosis and glaucoma with chronic therapy

c)
  1. Growth suppression

d)
  1. Need for reduced glucocorticoid dosing during times of increased stress

53.

Which of the following medications is used to treat Cushing’s disease?

a)

Clotrimazole

b)

Propylthiouracil

c)

Mitotane

d)

Vasopressin

e)

Prednisone

54.

A patient was recently discharged from the hospital with a new diagnosis of hypothyroidism. The patient was prescribed with levothyroxine. However, the patient has not started that medication but instead, is trying to manage the thyroid problem by taking iodine supplements. You are assigned to this patient to provide transition of care. Which of the following action should you take?

a)

Have patient continue the supplement and make an appointment for primary care

b)

Advise patient to start levothyroxine while continuing the supplement

c)

Advise patient to start levothryoxine and stop the supplement

d)

Have patient stop the supplement and make an appointment with primary care

e)

This is not part of transition of care activity, therefore, refer this to an endocrinologist

55.

Decreased ketoconazole absorption may occur if it is administered concomitantly with which of the following?

a)

Antacids

b)

Food

c)

Warfarin

d)

Cyclosporine

e)

Clarithromycin

56.

You are a pharmacist that practice under collaborative practice agreement with prescriptive authority at family medicine clinic. You are providing a comprehensive medication management and have a patient who has been taking levothyroxine without any lab monitoring. Last lab was drawn 2 years ago. The patient has been taking the same dose. What would be the most appropriate step to take first?

a)

Refer to endocrinologist

b)

Order TSH

c)

Order thyroid scan

d)

Order EKG

e)
  • Order T3


57.

A patient has been experiencing increased fatigue, myalgia, and weight gain since her treatment with radioactive therapy for Grave’s disease. Lab analysis will be needed for confirmation, but what is the most likely diagnosis based on her symptoms today?

a)

Hyperthyroidism

b)

Hypothyroidism

c)

Graves’ disease

d)

Thyroid storm

58.

A physician asks you if amiodarone is associated with any effects on thyroid function. Which of the following statements are accurate to include in your response? (Select ALL that apply)

a)

Amiodarone may result in hyperthyroidism

b)

Amiodarone may result in hypothyroidism

c)

The high iodine content in amiodarone appears to be a factor in causing thyroid dysfunction

d)

Amiodarone may exert direct toxicity on thyroid follicular cells

59.

Which of the following antihyperglycemics have an increased risk of pancreatitis? (Select ALL that apply)

a)

Biguanides

b)

DPP-4 inhibitors

c)

GLP-1 receptor agonists

d)

Insulin

60.

Which of the following can be causes of hypothyroidism? (Select ALL that apply)

a)

Congenital condition

b)

Thyroidectomy

c)

Iodine deficiency

d)

Drug-induced

e)

Autoimmune Disorder