N4 test Adrenal Hypersecretion Disorders

Price: Pathophysiology, 6th Edition
Study Questions Chapter 61: Adrenal Hypersecretion Disorders

1. When synthetic glucocorticoids are administered orally over a long time, which of the following events is likely to occur?
A. The adrenal gland continues to function normally.
B. The hypothalamic-pituitary axis is suppressed.
C. Corticotropin-releasing hormone (CRH) and adrenocorticotropic hormone (ACTH) levels are increased.
D. Endogenous cortisol secretion is stimulated.

2. Abrupt interruption of long-term corticosteroid therapy may result in:
A. Hyperglycemia
B. Severe salt depletion
C. Nausea, vomiting, hypotension
D. Marked hyperpigmentation

3. Mrs. A., 35 years of age, has the typical signs and symptoms of Cushing's syndrome. All the following signs and symptoms are characteristic of this condition except:
A. Moon face (full, round face)
B. Hypotension
C. Purple abdominal striae
D. Truncal obesity
E. Osteoporosis

4. Which of the following are characteristic metabolic effects of aldosterone?
A. Decreased potassium excretion
B. Sodium retention
C. Regulation of blood glucose
D. Suppression of ACTH release

5. Primary aldosteronism occurs when the overproduction of aldosterone results from a tumor or enlargement of the:
A. Pituitary gland
B. Adrenal cortex
C. Adrenal medulla
D. Hypothalamus

6. The direct effect of stress is an increased secretion of corticotropin by the anterior pituitary. Corticotropin acts on the adrenal cortex to increase secretion, primarily, of:
A. Glucocorticoids
B. Mineralocorticoids
C. Epinephrine

7. Cushing's syndrome may develop when which of the following secretes abnormal amounts of the stated hormone?
A. Adrenal cortex, aldosterone
B. Anterior pituitary, aldosterone
C. Adrenal cortex, ACTH
D. Anterior pituitary, ACTH

8. In physiologic testing for forms of Cushing's syndrome, patients who respond to metyrapone administration with an increase in ACTH release usually have which form of the disease?
A. Ectopic
B. Iatrogenic
C. Primal adrenal
D. Pituitary

9. Manifestations of virilism include all the following except:
A. Acne
B. Receding hairline, balding
C. Decreased body hair growth
D. Clitoral enlargement
E. Deepening of voice

10. Pheochromocytoma is:
A. Found only in the adrenal medulla
B. Manifested by hypotension
C. A catecholamine-producing tumor
D. Most often malignant

11. The urinary excretion of high levels of which of the following is important in establishing the diagnosis of pheochromocytoma?
A. Free cortisol
B. Potassium
C. Catecholamines and their metabolites
D. Aldosterone

12. Glucocorticoids affect the following when present in excess: (More than one answer may be correct.)
A. Adipose tissue distribution
B. The immune system
C. Protein metabolism
D. Carbohydrate metabolism

13. Which of the following pathologic conditions may cause Cushing's syndrome? (More than one answer may be correct.)
A. Pituitary adenoma
B. Adrenal adenoma
C. Ectopic hormone production by a neoplasm
D. Atrophy of the adrenal glands

14. Which of the following diagnostic tests can be used to determine whether Cushing's syndrome is caused by an adrenal neoplasm or by an ACTH-secreting pituitary microadenoma? (More than one answer may be correct.)
A. Adrenal computed tomography
B. Adrenal biopsy
C. Adrenal photoscanning
D. Myelography

15. Which of the following findings are characteristic of primary aldosteronism? (More than one answer may be correct.)
A. Hypokalemia
B. Hyponatremia
C. Hypertension
D. Nephrotic syndrome

16. A woman with hirsutism may present with which of the following signs and symptoms? (More than one answer may be correct.)
A. Amenorrhea or irregular menstrual periods
B. Increased breast size
C. Hair growth under the chin
D. Increased fertility

17. Androstenedione, a steroid precursor of testosterone, is: (More than one answer may be correct.)
A. Produced in the ovary and adrenal cortex of women
B. Produced only in male testes
C. A 17-ketosteroid
D. Present in higher concentration in the plasma of hirsute and virilized women
E. A less potent androgen than dehydroepiandrosterone

18. Congenital adrenal hyperplasia, of the 21-hydroxylase variety, is characterized by: (More than one answer may be correct.)
A. A masculinized genetically female fetus
B. Hyponatremia and hyperkalemia when accompanied by aldosterone deficiency (Note: feminization of a genetically male infant is rare and only occurs when there is also a block of androgen synthesis; when CAH is severe aldosterone deficiency will occur, which is more common)
C. High ACTH levels
D. Low serum cortisol levels
E. Increased urinary 17-ketosteroid level

19. Which of the following conditions may result in excessive androgen production? (More than one answer may be correct.)
A. Polycystic ovary syndrome
B. Arrhenoblastoma
C. Adrenal carcinoma
D. Hilus cell tumor of the ovary

20. Signs and symptoms of pheochromocytoma include paroxysmal episodes of: (More than one answer may be correct.)
A. Severe hypertension
B. Flushing and profuse diaphoresis
C. Severe headache
D. Tachycardia and dysrhythmias

21.The usual treatment of pheochromocytoma consists of: (More than one answer may be correct.)
A. Surgical excision of the tumor
B. Presurgical treatment with an alpha-adrenergic blocker such as phenoxybenzamine
C. Radiation therapy
D. Chemotherapy

22. CRH is secreted by the hypothalamus.
True False

23. CRH stimulates the release of ACTH from the anterior pituitary.
True False

24. High plasma cortisol levels exert a negative feedback effect on CRH release in the normal state.
True False

25. CRH directly initiates the secretion of cortisol.
True False

26. A deficiency of 21-hydroxylase causes an increase in cortisol production and a decrease in ACTH secretion.
True False