Glucocorticosteroids

Question 1

True/False: oral prednisone therapy increases synthesis of interleukin-2.

Answer 1

False, prednisone suppresses the immune response, including inhibiting IL-2 synthesis

Question 2

True/False: intra-articular injections decrease the local inflammatory response.

Answer 2

True

Question 3

True/False: high doses of glucocorticosteroids are used to treat osteonecrosis.

Answer 3

False

Question 4

True/False: oral methylprednisone decreases the risk of NSAID-induced gastric ulceration.

Answer 4

False, Glucocorticoids may increase the risk of gastric ulceration, especially when combined with NSAIDs

Question 5

True/False: oral prednisolone causes hypertension.

Answer 5

True, Prednisolone causes sodium and water retention, which can increase blood pressure

Question 6

True/False: oral prednisolone increases blood glucose levels.

Answer 6

True, It induces gluconeogenesis and insulin resistance, leading to hyperglycaemia

Question 7

True/False: in the elderly, oral glucocorticosteroid use increases fluid retention.

Answer 7

True, Elderly patients are more sensitive to mineralocorticoid effects like sodium retention and oedema

Question 8

True/False: glucocorticosteroid receptors are located in the cell membrane.

Answer 8

False, receptors are intracellular

Question 9

True/False: repeated cortisone injections increase the risk of osteonecrosis.

Answer 9

True

Question 10

True/False: the use of oral methylprednisolone for >2 weeks increases circulating levels of ACTH.

Answer 10

False, Prolonged corticosteroid use suppresses the hypothalamic-pituitary-adrenal (HPA) axis, reducing ACTH production due to negative feedback

Question 11

True/False: topical hydrocortisone inhibits inflammation.

Answer 11

True

Question 12

True/False: fluticasone is used in the treatment of asthma.

Answer 12

True

Question 13

True/False: fluticasone is used to treat oral candida infection.

Answer 13

False

Question 14

True/False: oral prednisolone causes hyperglycaemia

Answer 14

True

Question 15

True/false: prednisone inhibits cox1.

Answer 15

False, Prednisone does not directly inhibit COX-1 or COX-2 like NSAIDs. It inhibits phospholipase A2, which reduces arachidonic acid, the precursor for both COX pathways.

Question 16

True/false: in the treatment if osteoarthritis, dexamethasone is injected intra-articularly.

Answer 16

True, however, triamcinolone is more commonly used

Question 17

True/false: an adverse effect of glucocorticosteroids is the anabolic effects on muscle.

Answer 17

False, Glucocorticosteroids have catabolic effects on muscle, leading to muscle wasting, not anabolic effects.

Question 18

True/false: long-term treatment with prednisone causes dysregulation of the HPA axis.

Answer 18

True

Question 19

True/false: hydrocortisone stimulates bone growth in children.

Answer 19

False, Long-term glucocorticoid use can cause growth suppression and bone resorption, especially in children.

Question 20

True/false: treatment with betamethasone increases the risk of osteoporosis in cancer patients.

Answer 20

True

Question 21

True/false: glucocorticosteroids stimulate T-cell response.

Answer 21

False

Question 22

True/false: glucocorticosteroids increase the response to vaccines.

Answer 22

False, they blunt the immune response, leading to reduced vaccine efficacy

Question 23

True/false: glucocorticosteroids decrease prostaglandin synthesis.

Answer 23

True, By inhibiting phospholipase A2, glucocorticoids reduce prostaglandin and leukotriene synthesis

Question 24

True/false: glucocorticosteroids stimulate wound healing.

Answer 24

False, impairs wound healing by inhibiting inflammation, fibroblast proliferation, and collagen synthesis

Question 25

True/false: prednisone increases prostaglandins at the site of inflammation.

Answer 25

False

Question 26

True/false: prednisone stimulates the transcription of lipocortin.

Answer 26

True, Lipocortin (aka annexin-1) inhibits phospholipase A2

Question 27

True/false: prednisone is contraindicated in asthma.

Answer 27

False

Question 28

True/false: prednisone is an immunosuppressant.

Answer 28

True

Question 29

True/false: glucocorticosteroids decrease phospholipase activity.

Answer 29

True, They induce lipocortin, which inhibits phospholipase A2

Question 30

True/false: glucocorticosteroids increase the activity of NFKB.

Answer 30

False, Glucocorticoids suppress NF-κB activity, reducing transcription of pro-inflammatory genes

Question 31

True/false: Increase the synthesis of surfactant.

Answer 31

True, Especially in preterm labor, corticosteroids (eg: betamethasone) are given to stimulate fetal surfactant production

Question 32

True/false: glucocorticosteroids stimulate the formation of annexin1.

Answer 32

True

Question 33

True/false: beclomethasone is given to asthmatic pts to reduce inflammation.

Answer 33

True

Question 34

True/false: prednisone decreases plasma glucose levels.

Answer 34

False

Question 35

True/false: glucocorticosteroids inhibit the growth of oral candidiasis.

Answer 35

False

Question 36

Which of the following is a common adverse effect of long-term oral prednisolone therapy? A. Enhanced wound healing B. Hyperglycaemia C. Increased T-cell activation D. Increased bone density

Answer 36

Hyperglycaemia

Question 37

Glucocorticosteroids suppress inflammation by inhibiting which enzyme? A. Cyclooxygenase-1 (COX-1) B. Thymidylate synthase C. Phospholipase A2 D. Adenylate cyclase

Answer 37

Phospholipase A2

Question 38

Which statement about glucocorticosteroid receptors is TRUE? A. They are located in the plasma membrane. B. They bind prostaglandins. C. They are located intracellularly and alter gene transcription. D. They are only found in immune cells.

Answer 38

They are located intracellularly and alter gene transcription.

Question 39

Fluticasone is commonly used for: A. Oral fungal infections B. Asthma maintenance therapy C. Promoting growth in children D. Treating bacterial pneumonia

Answer 39

Asthma maintenance therapy

Question 40

Which of the following increases the risk of oral candidiasis? A. Oral amoxicillin B. Beclomethasone C. Inhaled fluticasone D. Prednisone + calcium

Answer 40

Inhaled fluticasone

Question 41

Which of the following accurately describes the effect of glucocorticoids on the immune system? A. They increase IL-2 synthesis B. They stimulate T-cell proliferation C. They suppress the HPA axis and reduce ACTH levels D. They increase the response to vaccines

Answer 41

They suppress the HPA axis and reduce ACTH levels

Question 42

Which corticosteroid is used in pregnancy to promote fetal lung maturity? A. Hydrocortisone B. Dexamethasone C. Betamethasone D. Methylprednisolone

Answer 42

Betamethasone

Question 43

Prednisone leads to reduced synthesis of prostaglandins by: A. Inhibiting COX-1 directly B. Inhibiting phospholipase A2 via annexin-1 C. Blocking arachidonic acid uptake D. Increasing prostaglandin dehydrogenase

Answer 43

Inhibiting phospholipase A2 via annexin-1

Question 44

A 65-year-old patient is prescribed long-term prednisone. Which of the following precautions is most appropriate? A. Reduce dietary protein intake B. Avoid all physical activity C. Monitor bone mineral density D. Limit vitamin D consumption

Answer 44

Monitor bone mineral density

Question 45

Glucocorticosteroids suppress which transcription factor involved in inflammation? A. NF-κB B. mTOR C. STAT3 D. PPAR-γ

Answer 45

NF-κB

Question 46

True/false: oral prednisolone used for a period longer than 6 weeks causes: muscle myopathy hypoglyceamia suppression of HPA axis reversal of osteoporosis immunosuppression

Answer 46

T - muscle myopathy F - hypoglycaemia T - suppression of HPA axis F - reversal of osteoporosis T - immunosuppression

Question 47

True/false: high dose IV betamethasone therapy increases the risk of aseptic osteonecrosis.

Answer 47

True

Question 48

True/false: ocular administration of prednisone aggravates glaucoma.

Answer 48

True

Question 49

True/false: oral dexamethasone increases plasma IL-1 levels.

Answer 49

False, corticosteroids increase intraocular pressure

Question 50

True/false: when a chronically ill patient on daily oral prednisone therapy is scheduled for surgery, the dose of prednisone is reduced.

Answer 50

False, pts are at risk of adrenal insufficiency due to HPA axis suppression

Question 51

True/false: the glucocorticoid receptor is “trapped” in the cellular cytoplasm by heat shock proteins.

Answer 51

True

Question 52

True/false: oral prednisone therapy stimulates the T-cell response.

Answer 52

False

Question 53

True/false: corticosteroid therapy in children increases the risk of cataracts.

Answer 53

True

Question 54

True/false: betamethasone is used in acute episodes of multiple sclerosis.

Answer 54

True

Question 55

True/false: orally administered dexamethasone stimulates the release of ACTH from the anterior pituitary gland.

Answer 55

False

Question 56

True/false: continuous topical use of glucocorticosteroids causes thinning of the skin.

Answer 56

True

Question 57

True/false: patients on continuous oral glucocorticosteroids therapy require a reduction in the dose prior to elective surgery.

Answer 57

False

Question 58

True/false: oral betamethasone increases skeletal muscle mass.

Answer 58

False, catabolic hormone

Question 59

True/false: dexamethasone stimulates the synthesis of surfactant in the lungs of premature neonates.

Answer 59

True

Question 60

True/false: fluticasone is more likely to cause osteoporosis than methylprednisolone.

Answer 60

False, Systemic corticosteroids carry a higher risk of osteoporosis than inhaled corticosteroids

Question 61

True/false: triamcinolone increases the activity of B-lymphocytes.

Answer 61

False

Question 62

True/false: in the event of an adrenal crisis, hydrocortisone is contraindicated.

Answer 62

False, Hydrocortisone is the treatment of choice in adrenal crisis

Question 63

True/false: betamethasone increases the gene transcription of cyclooxygenase II.

Answer 63

False

Question 64

True/false: oral fluticasone is used in the treatment of rheumatoid arthritis.

Answer 64

False

Question 65

True/false: betamethasone enhances ACTH release from the pituitary gland.

Answer 65

False

Question 66

True/false: the steroid receptor complex inhibits the translation of TNFalfa-mRNA.

Answer 66

True