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Cushing syndrome:
- A. may be caused by steroid (prednisone) therapy.
- B. is caused by adrenal insufficiency.
- C. is characterized by hypoglycemia and low blood volume.
- D. is treated with growth hormone.
Correct Answer: A
Rationale: The correct answer is A because Cushing syndrome is typically caused by prolonged exposure to high levels of cortisol, which can result from steroid therapy like prednisone. This leads to symptoms such as weight gain, high blood pressure, and muscle weakness. Adrenal insufficiency (B) is actually the opposite condition. Cushing syndrome is characterized by hyperglycemia and increased blood volume, making choices C incorrect. Growth hormone is not a primary treatment for Cushing syndrome, making choice D incorrect.
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Addison's disease frequently causes skin pigment changes. When teaching the patient about medications used for Addison's disease, it is important that he or she understands:
- A. To take plenty of water (at least 8 ounces or 240 mL) with the medication.
- B. Proper subcutaneous injection technique.
- C. That they continue for life.
- D. That they can be stopped when symptoms abate.
Correct Answer: C
Rationale: Patients with Addison's disease require lifelong hormone replacement therapy to manage the condition as the adrenal glands do not produce enough cortisol.
Mole for mole, which of the following has the greatest effect on plasma osmolality?
- A. Progesterone
- B. Cortisol
- C. Vasopressin
- D. Aldosterone
Correct Answer: C
Rationale: Plasma osmolality is primarily regulated by the concentration of solutes in the blood. Vasopressin, also known as antidiuretic hormone (ADH), plays a key role in regulating water reabsorption in the kidneys, thus affecting plasma osmolality. When plasma osmolality increases, vasopressin is released to increase water reabsorption, leading to a decrease in plasma osmolality. Progesterone, cortisol, and aldosterone do not directly influence water reabsorption and therefore do not have as significant an impact on plasma osmolality as vasopressin.
A 35-year-old female presents to your office for a regular check-up. Her only complaint is recurrent migraine headaches, which have increased in frequency over the years. On examination, her blood pressure is elevated at 150/70. You decide to start her on antihypertensive therapy that is also used for prophylaxis of migraines. Which medication is it?
- A. Clonidine
- B. Prazosin
- C. Hydrochlorothiazide
- D. Propranolol
Correct Answer: D
Rationale: The correct answer is D: Propranolol. Propranolol is a beta-blocker that is commonly used for migraine prophylaxis. It helps reduce the frequency and severity of migraines by blocking the action of adrenaline on blood vessels in the brain. In this case, the patient has elevated blood pressure and migraines, so starting her on propranolol can address both issues effectively.
Choice A: Clonidine is an alpha-2 agonist used for hypertension, but it is not commonly used for migraine prophylaxis.
Choice B: Prazosin is an alpha-1 blocker primarily used for the treatment of hypertension, but it is not typically used for migraine prophylaxis.
Choice C: Hydrochlorothiazide is a diuretic used for hypertension by reducing blood volume, but it is not effective for migraine prophylaxis.
In summary, propranolol is the most appropriate choice as it addresses both the elevated blood pressure and the recurrent
Identify the gland that secretes cortisol and aldosterone.
- A. thyroid
- B. parathyroid
- C. pancreas
- D. adrenal
Correct Answer: D
Rationale: The correct answer is D: adrenal gland. The adrenal gland secretes cortisol and aldosterone. Cortisol is essential for regulating metabolism, immune response, and stress. Aldosterone helps regulate blood pressure and electrolyte balance. The other choices are incorrect because the thyroid gland (A) secretes hormones like thyroid hormone and calcitonin, the parathyroid gland (B) secretes parathyroid hormone, and the pancreas (C) secretes insulin and glucagon. Only the adrenal gland (D) secretes cortisol and aldosterone, making it the correct answer.
Adrenaline combination with local anesthetics has the following effects EXCEPT:
- A. Reduces the absorption of local anesthetic
- B. Increases the duration of its local anesthetic activity
- C. Decreases the toxicity of the local anesthetic
- D. Increases blood flow to the injection area
Correct Answer: D
Rationale: Correct Answer: D. Increases blood flow to the injection area.
Rationale:
1. Adrenaline is a vasoconstrictor that reduces blood flow in the injection area.
2. By constricting blood vessels, adrenaline limits the absorption of the local anesthetic, leading to prolonged local action.
3. Adrenaline also helps in reducing the systemic toxicity of the local anesthetic by limiting its absorption.
4. Therefore, the correct answer is D as adrenaline does not increase blood flow to the injection area.