All the following are complications of large doses of glucocorticoids, EXCEPT:

Correct Answer: C

Rationale: In this question focusing on complications of large doses of glucocorticoids, the correct answer is option C) Hypersensitivity reactions. Glucocorticoids are known to suppress the immune system, so hypersensitivity reactions are less likely to occur with their use. Option A) Hypertension is a known complication of large doses of glucocorticoids due to their effect on sodium and water retention, leading to increased blood pressure. Option B) Peptic ulcer is also a common complication as glucocorticoids can lead to increased gastric acid secretion and decreased mucosal protection. Option D) Spread of infection is another potential complication of glucocorticoid use as they can suppress the immune response, making individuals more susceptible to infections and impairing the body's ability to fight off pathogens. In an educational context, understanding the complications of pharmacological agents like glucocorticoids is crucial for healthcare professionals to make informed decisions about their use. It highlights the importance of weighing the benefits of these drugs against their potential adverse effects, and the need for close monitoring when administering them to patients. This knowledge is essential for pharmacology students, nurses, physicians, and other healthcare providers to ensure safe and effective patient care.

Correct Answer: A

Rationale: Bromocriptine (choice A), a dopamine agonist, treats hyperprolactinemia (causing amenorrhea, infertility, galactorrhea) by inhibiting prolactin, restoring ovulation. Mental health screening avoids psychosis risk. Desmopressin (choice B), HGH (choice C), and Octreotide (choice D) target different conditions. Bromocriptine fits the scenario.

Correct Answer: B

Rationale: In early pregnancy, it is crucial for women with diabetes mellitus to carefully manage their medications to ensure the best outcomes for both the mother and the developing fetus. The correct answer, option B, stating that the lady must convert to insulin therapy, is the most appropriate choice in this scenario. During the early stages of pregnancy, sulphonylurea drugs are not recommended due to their potential risks to the developing fetus. Insulin therapy is considered the safest option for managing blood glucose levels in pregnant women with diabetes. Insulin does not cross the placenta, making it the preferred choice to maintain tight glycemic control without posing harm to the fetus. Option A is incorrect because continuing sulphonylurea drugs can increase the risk of adverse outcomes for the fetus. Option C, stopping all treatment, is dangerous as uncontrolled blood sugar levels can lead to serious complications for both the mother and the baby. Option D, converting to diet only, is inadequate for managing diabetes during pregnancy as it may not provide sufficient control over blood glucose levels. Educationally, it is important for healthcare providers to be aware of the appropriate management strategies for pregnant women with diabetes to optimize outcomes. Understanding the risks and benefits of different treatment options is essential in providing safe and effective care for this population. Insulin therapy remains the cornerstone of management for pregnant women with diabetes to ensure the best possible health for both the mother and the unborn child.

Correct Answer: C

Rationale: The correct answer is option C) Slow reduction of the glucocorticoid dose over 1-2 weeks. Rationale: - Glucocorticoids, when administered in high doses over a prolonged period, can suppress the body's natural production of corticosteroids. Abruptly stopping glucocorticoids can lead to adrenal insufficiency due to the body's inability to produce enough cortisol to meet its needs. - Gradually tapering the dose of glucocorticoids allows the adrenal glands to gradually resume their normal function. This tapering process helps prevent adrenal crisis and minimizes the risk of withdrawal symptoms such as fatigue, weakness, and hypotension. - Options A and B are incorrect because adding metyrapone or spironolactone does not address the need for tapering off glucocorticoids and may not prevent adrenal insufficiency. - Option D, immediate stoppage of glucocorticoids, is incorrect as it can precipitate adrenal crisis and potentially life-threatening complications. Educational Context: Understanding the appropriate protocols for withdrawing glucocorticoids is crucial for healthcare professionals managing patients on long-term glucocorticoid therapy. Sudden discontinuation can have serious consequences, emphasizing the importance of a gradual tapering approach to allow the body to adjust and resume normal cortisol production. This knowledge is essential for ensuring patient safety and optimal outcomes in clinical practice.

Correct Answer: B

Rationale: Ethinyl estradiol (choice B) is the synthetic estrogen in most combined oral contraceptives (COCs), paired with progestins for ovulation suppression and cycle control, due to its potency and oral bioavailability. Clomiphene (choice A) induces ovulation, Estrone (choice C) is weaker and not used, Norgestrel (choice D) is a progestin. Ethinyl estradiol's widespread use reflects its efficacy in contraception, critical for understanding COC pharmacology and patient counseling.