Hydrocortisone exerts the following actions:

Correct Answer: C

Rationale: Hydrocortisone is a glucocorticoid hormone that affects the regulation of electrolyte balance in the body. In the kidneys, hydrocortisone acts to increase the excretion of potassium (K+) while also enhancing the reabsorption of calcium (Ca2+). This results in a decrease in potassium levels in the blood (hypokalemia) and an increase in calcium levels (hypercalcemia). Therefore, the correct action of hydrocortisone is to decrease potassium excretion and increase calcium excretion.

Correct Answer: A

Rationale: Corticosteroid therapy can exacerbate or worsen several medical conditions. However, it typically does not aggravate congenital adrenal hyperplasia (CAH). CAH is a genetic disorder characterized by a deficiency of certain enzymes in the adrenal glands, leading to problems with hormone production. Corticosteroid therapy is actually a key component of the treatment for CAH, helping to replace the deficient hormones and manage symptoms. In contrast, corticosteroid therapy can worsen conditions such as diabetes mellitus, hypertension, and peptic ulcer disease by affecting glucose metabolism, blood pressure regulation, and gastric mucosal integrity, respectively.

Correct Answer: B

Rationale: Corticosteroids can cause a rise in blood pressure primarily due to their mineralocorticoid action. Mineralocorticoids such as aldosterone play a key role in regulating blood pressure by controlling sodium and water balance in the body. Corticosteroids, including synthetic ones like prednisone, can mimic the effects of aldosterone, leading to increased sodium reabsorption in the kidneys and subsequent water retention. This results in fluid buildup and elevated blood pressure. It is important for healthcare providers to monitor blood pressure regularly in patients who are prescribed corticosteroids, especially for long-term use, to manage and minimize this potential adverse effect.

Correct Answer: D

Rationale: Testosterone is converted to dihydrotestosterone by the enzyme 5α-reductase, which is involved in various physiological processes in males. However, spermatogenesis does not directly depend on dihydrotestosterone. Spermatogenesis is primarily regulated by follicle-stimulating hormone (FSH) and luteinizing hormone (LH). While testosterone plays a role in supporting spermatogenesis, dihydrotestosterone specifically is not required for this process. Therefore, the conversion of testosterone to dihydrotestosterone by 5α-reductase is not directly involved in spermatogenesis.

Correct Answer: B

Rationale: Anabolic steroids are synthetic derivatives of testosterone, which exhibit both anabolic (muscle-building) and androgenic (masculinizing) properties. However, some anabolic steroids are designed to have more selective anabolic effects with reduced androgenic side effects. Therefore, statement B is correct.