Corticosteroids and Sex Hormones (OCPs, Androgens) MCQs

Pharmacology · 81 free questions with answers & explanations.

  1. A woman is prescribed combined oral contraceptive pills and notices that her blood pressure rises after 3 months. The mechanism responsible is:
  2. Regarding the Hypothalamic-Pituitary-Adrenal (HPA) axis suppression by long-term corticosteroid therapy, which statement is most accurate?
  3. A patient on long-term glucocorticoids undergoes elective surgery. Perioperative 'stress dosing' is required. Which physiological mechanism necessitates supraphysiological perioperative corticosteroid coverage?
  4. Combined oral contraceptive pills (COCPs) failure rate in women taking rifampicin is due to which specific drug interaction?
  5. Mifepristone (RU486) is used for medical termination of pregnancy. Beyond its anti-progestational action, it also has clinically relevant effects on which other receptor?
  6. Ulipristal acetate (UPA) is a selective progesterone receptor modulator (SPRM) used as emergency contraception up to 120 hours post-coitus. Its efficacy beyond 72 hours compared to levonorgestrel is explained by:
  7. Mifepristone acts as a competitive antagonist at progesterone receptors. When used for medical termination of pregnancy, it causes sensitisation of the uterus to which subsequent drug?
  8. A patient on high-dose corticosteroids for 3 months develops secondary adrenal insufficiency. The pharmacological basis for this complication is:
  9. Ulipristal acetate (UPA) used as emergency contraception has a mechanism distinct from levonorgestrel. UPA's primary contraceptive mechanism involves:
  10. The glucocorticoid-sparing effect of mifepristone in Cushing's syndrome is paradoxical because mifepristone is a glucocorticoid receptor (GR) antagonist, not a steroid synthesis inhibitor. ACTH and cortisol levels typically rise on mifepristone because:
  11. Enzalutamide, used for castration-resistant prostate cancer, has a different mechanism than bicalutamide despite both being androgen receptor (AR) antagonists. Enzalutamide additionally prevents:
  12. A 30-year-old woman with secondary adrenal insufficiency is managed with hydrocortisone replacement. She is scheduled for an elective surgery. The appropriate perioperative steroid management is based on which physiological principle?
  13. Mifepristone (RU-486) is used for medical abortion and also for Cushing's syndrome. The mechanism by which mifepristone treats hypercortisolaemia is different from its abortifacient action. In Cushing's syndrome it acts as:
  14. A 28-year-old woman taking combined OCP (ethinyl estradiol + levonorgestrel) develops a DVT. The prothrombotic mechanism of ethinyl estradiol involves:
  15. Mifepristone is used for medical abortion but also as a cortisol antagonist in Cushing's syndrome. At the glucocorticoid receptor (GR), mifepristone acts as a:
  16. Ulipristal acetate (UPA) used for emergency contraception and uterine fibroids is a selective progesterone receptor modulator (SPRM). How does its mechanism differ from mifepristone despite both being antiprogestins?
  17. A transgender man on intramuscular testosterone therapy presents with polycythemia. Which pharmacokinetic property of IM testosterone is most responsible for this adverse effect?
  18. Mifepristone (RU-486) is a progesterone and glucocorticoid receptor antagonist. When used as an abortifacient in early pregnancy, why is it always combined with a prostaglandin (misoprostol) rather than used alone?
  19. A patient with congenital adrenal hyperplasia (21-hydroxylase deficiency) is on hydrocortisone for glucocorticoid replacement. The dose is titrated to suppress ACTH-driven androgen excess. Which glucocorticoid receptor signaling mechanism explains the therapeutic anti-inflammatory and HPA-suppressive effect?
  20. Ulipristal acetate used for emergency contraception has a broader window of efficacy (up to 120 hours) compared to levonorgestrel (72 hours) because it acts as:
  21. A patient develops Cushingoid features while using intranasally administered corticosteroids for chronic rhinitis. The systemic absorption is highest with which agent?
  22. A woman on combined oral contraceptive pills containing ethinyl estradiol develops a deep vein thrombosis. The most specific pharmacodynamic mechanism linking ethinyl estradiol to venous thromboembolism is:
  23. Mifepristone's mechanism of action in medical abortion differs from its anti-glucocorticoid action. In abortion at 7 weeks gestation, mifepristone acts by:
  24. Mifepristone (RU-486) has both antiprogesterone and antiglucocorticoid properties. The antiglucocorticoid effect results in a clinically significant pharmacological consequence in patients with Cushing's syndrome, which is:
  25. Ulipristal acetate (emergency contraceptive) is a selective progesterone receptor modulator (SPRM). It differs from levonorgestrel (Plan B) in its primary mechanism and efficacy window because:
  26. Ulipristal acetate (UPA), used both as emergency contraception and for uterine fibroids, acts as a selective progesterone receptor modulator (SPRM). What distinguishes its receptor pharmacology from mifepristone?
  27. In patients with septic shock who appear cortisol-unresponsive (relative adrenal insufficiency), high-dose corticosteroids were found harmful in trials. Current evidence supports which specific steroid approach?
  28. A patient on long-term high-dose prednisolone is scheduled for surgery. She has been on 10 mg/day for 9 months. The reason for perioperative steroid supplementation is:
  29. Mifepristone (RU486) causes cervical ripening and myometrial sensitisation to prostaglandins primarily by:
  30. Clomiphene citrate induces ovulation in anovulatory women by:
  31. A woman taking a combined oral contraceptive containing ethinylestradiol and levonorgestrel starts rifampicin for latent TB prophylaxis. The contraceptive failure risk arises from:
  32. Mifepristone (RU-486) mechanism for medical abortion involves which receptor-level pharmacology?
  33. Ulipristal acetate, used in emergency contraception up to 120 hours after unprotected intercourse, acts as:
  34. Which of the following correctly explains why inhaled corticosteroids (ICS) like fluticasone are preferred over systemic steroids for long-term asthma control?
  35. A woman taking a combined oral contraceptive pill (COCP) is prescribed rifampicin for tuberculosis. Rifampicin reduces OCP efficacy primarily by:
  36. Which corticosteroid has the highest mineralocorticoid to glucocorticoid potency ratio, making it most appropriate for adrenal insufficiency requiring both cortisol replacement AND mineralocorticoid supplementation?
  37. Mifepristone (RU486) is used for medical abortion. It is also a glucocorticoid receptor antagonist. Its primary mechanism for termination of early pregnancy is:
  38. A woman on combined oral contraceptive pills (COCPs) is started on rifampicin for TB treatment. Her GP advises extra contraceptive precautions. The pharmacokinetic basis for this interaction is:
  39. Mifepristone (RU-486) is used for medical termination of pregnancy. Its mechanism at the molecular receptor level is:
  40. A patient with metastatic prostate cancer is treated with enzalutamide. Unlike older anti-androgens (flutamide), enzalutamide does not cause 'anti-androgen withdrawal syndrome'. This is because:
  41. A woman presents with hirsutism and acne. She is started on spironolactone. The rationale for this use is:
  42. Mifepristone (RU-486) is used for medical termination of pregnancy (MTP) and is always combined with a prostaglandin (e.g., misoprostol). The mechanism of mifepristone is:
  43. Which corticosteroid would be MOST appropriate for a patient with dermatitis requiring a high-potency topical agent to avoid hypothalamic-pituitary-adrenal (HPA) axis suppression with prolonged use?
  44. Mifepristone (RU-486) is used as a medical abortifacient and in Cushing syndrome. Its mechanism is:
  45. Long-term corticosteroid therapy causes adrenal suppression through which mechanism?
  46. Mifepristone (RU-486) is used for medical termination of pregnancy in combination with misoprostol. Its mechanism involves:
  47. A woman taking combined oral contraceptive pills is prescribed rifampicin for TB treatment. She is counseled about potential contraceptive failure because rifampicin:
  48. Spironolactone is used as an anti-androgen in female patients with polycystic ovarian syndrome (PCOS). Beyond its aldosterone-receptor blockade, its antiandrogenic mechanism is:
  49. A woman on a combined OCP containing 30 mcg ethinyl estradiol and 150 mcg levonorgestrel requires rifampicin for latent TB treatment. The pharmacist warns of contraceptive failure. The recommended approach is:
  50. A 40-year-old man with autoimmune hepatitis on prednisolone for 8 months develops new-onset back pain. Imaging shows multiple vertebral compression fractures. The mechanism of corticosteroid-induced osteoporosis is best described as:
  51. Glucocorticoids exert their anti-inflammatory effects through two broad genomic mechanisms. 'Transrepression' — the primary mechanism for anti-inflammatory effects — involves:
  52. Ulipristal acetate (UPA) is a selective progesterone receptor modulator (SPRM) approved for uterine fibroids. Compared to mifepristone, UPA is preferred for fibroid therapy because:
  53. A patient on long-term high-dose glucocorticoid therapy for rheumatoid arthritis is planned for elective surgery. The concern for adrenal suppression is related to which mechanism?
  54. Ulipristal acetate (UPA) is used as emergency contraception and for uterine fibroids. Its receptor-level mechanism is:
  55. Mifepristone (RU-486) used for medical termination of pregnancy blocks which receptor, and what is its mechanism in facilitating cervical ripening and uterine contractions?
  56. Fludrocortisone is the drug of choice for primary adrenal insufficiency (Addison's disease) as mineralocorticoid replacement. Compared to hydrocortisone, fludrocortisone has:
  57. A 26-year-old woman taking a combined oral contraceptive pill (COC) is prescribed rifampicin for tuberculosis. The pharmacokinetic interaction that reduces OCP efficacy involves:
  58. A 26-year-old woman using combined OCP (ethinyl estradiol + levonorgestrel) develops deep vein thrombosis. The hormonal mechanism underlying increased VTE risk with estrogen-containing contraceptives is:
  59. A patient on long-term prednisolone (>5 mg/day for >3 months) undergoes major surgery. The anesthesiologist administers a 'stress dose' of hydrocortisone. The underlying concern is:
  60. Mifepristone (RU-486) blocks progesterone receptors but is also used to treat Cushing's syndrome. Which additional receptor interaction explains its use in hypercortisolism?
  61. Emergency contraception with levonorgestrel (Plan B) is most effective when taken within 72 hours of unprotected intercourse. Its primary mechanism of action when used for emergency contraception is:
  62. Emergency contraception with ulipristal acetate (UPA) is effective up to 120 hours post-coitus and is more effective than levonorgestrel. The mechanism of UPA is:
  63. Mifepristone used for medical abortion acts as an antiprogestogen. Its additional property that makes it useful combined with misoprostol is:
  64. Mifepristone (RU-486) is used for medical termination of pregnancy. Beyond progesterone receptor antagonism, mifepristone also has which additional clinically relevant receptor activity?
  65. A woman taking a combined oral contraceptive pill (OCP) containing ethinyl estradiol and levonorgestrel has a venous thromboembolism. The increased VTE risk is primarily due to which mechanism?
  66. Mifepristone (RU-486) causes abortion and is also used in Cushing's syndrome. Its mechanism in both indications involves:
  67. The progestogen-only pill (mini-pill, e.g., norethisterone 350 mcg daily) prevents pregnancy primarily by:
  68. A young woman on combined OCP (ethinylestradiol + levonorgestrel) for contraception is prescribed rifampicin for TB. She becomes pregnant despite continuing the OCP. The mechanism of OCP failure is:
  69. Mifepristone (RU-486) is used for medical termination of pregnancy and is followed by misoprostol 24-48 hours later. Mifepristone's mechanism of action at the progesterone receptor level is:
  70. A 32-year-old woman with severe asthma on long-term oral prednisolone develops iatrogenic Cushing's syndrome. Attempts to taper prednisolone cause worsening asthma. The physician plans to switch to inhaled fluticasone propionate. What pharmacokinetic property specifically minimizes systemic side effects of inhaled fluticasone compared to oral prednisolone?
  71. Ulipristal acetate is used for emergency contraception and also as treatment for uterine fibroids. Its mechanism of action on the uterine endometrium involves which specific receptor interaction?
  72. Mifepristone (RU-486) is a competitive antagonist at the progesterone receptor used for medical termination of pregnancy. It also has glucocorticoid receptor (GR) antagonism, making it useful in which condition?
  73. Ulipristal acetate (UPA) is a selective progesterone receptor modulator used as emergency contraception up to 120 hours post-coitus. Compared to levonorgestrel (LNG), its advantage at day 4–5 is mechanistically due to:
  74. Mifepristone (RU-486) terminates early pregnancy. It acts as a competitive antagonist at which receptor, and what is its additional anti-glucocorticoid action?
  75. Dexamethasone is preferred over hydrocortisone for suppression of adrenal androgen excess (e.g., CAH) and for fetal lung maturation. The pharmacological basis is:
  76. Ulipristal acetate (UPA) used as emergency contraception differs from levonorgestrel in its mechanism because:
  77. Mifepristone (RU-486) is used as a medical abortifacient. Its mechanism involves:
  78. A patient on long-term prednisolone develops adrenal suppression. Which feature best explains why morning dosing is preferred over evening dosing for chronic corticosteroid therapy?
  79. Dexamethasone is given to a pregnant woman at 28–34 weeks gestation for threatened preterm labor. The purpose is:
  80. A patient on long-term prednisolone for rheumatoid arthritis develops Cushing's syndrome. Which morning cortisol test result would confirm HPA axis suppression in this patient?
  81. A 28-year-old woman with PCOS and hirsutism is prescribed spironolactone. Beyond its diuretic action, spironolactone helps PCOS by:
Sponsored

Practise this topic as a timed set and track your accuracy.

Create a free account →