The following measure can minimise pituitary-adrenal suppression during long-term corticosteroid therapy:

Correct Answer: C

Rationale: The correct answer is C: Division of the daily dose in three equal 8-hourly doses. Dividing the daily dose helps maintain more stable blood levels of corticosteroids, reducing the risk of pituitary-adrenal suppression. By spreading the dose evenly throughout the day, the body is less likely to experience sudden peaks and troughs in cortisol levels. This approach mimics the body's natural cortisol production pattern, promoting a more balanced hormonal environment. Explanation for other choices: A: Using betamethasone instead of prednisolone does not address the issue of minimizing pituitary-adrenal suppression. B: Using prednisolone on alternate days may lead to fluctuating cortisol levels, which can contribute to pituitary-adrenal suppression. D: Administering the total daily dose at bedtime does not provide the consistent cortisol levels needed to minimize pituitary-adrenal suppression.

Correct Answer: D

Rationale: Danazol is a synthetic steroid derivative that is primarily used to treat conditions like amenorrhoea, endometriosis, and fibrocystic breast disease. However, it is not indicated for precocious puberty in male children. This is because Danazol can cause masculinization effects due to its androgenic properties, which can worsen the symptoms of precocious puberty in male children. Therefore, the correct answer is D. The other choices, A, B, and C, are incorrect as Danazol is commonly prescribed for these conditions due to its anti-estrogenic and androgenic effects.

Correct Answer: D

Rationale: The correct answer is D: Flutamide. Flutamide is a non-steroidal antiandrogen used in advanced prostate carcinoma. It works by blocking androgen receptors in the prostate, thereby inhibiting the growth of prostate cancer cells. When combined with a GnRH agonist, it helps reduce testosterone levels further, providing palliative treatment for advanced prostate cancer. A: Cyproterone acetate is another antiandrogen, but it is a steroidal one and not commonly used for this purpose. B: Danazol is not typically used in the treatment of advanced prostate carcinoma. C: Finasteride is a 5-alpha reductase inhibitor used for benign prostatic hyperplasia and male pattern baldness, not for advanced prostate cancer.

Correct Answer: A

Rationale: The correct answer is A because estrogens do not cause cornification of vaginal epithelium. Estrogens are responsible for proliferation of endometrium, maturation of graafian follicle, and anabolism. Cornification of vaginal epithelium is mainly influenced by androgens. So, the action described in choice A is not a direct effect of estrogens.

Correct Answer: D

Rationale: The correct answer is D: Atrophic vaginitis. In this condition, the primary treatment is usually local estrogen therapy to alleviate symptoms of vaginal dryness and discomfort. Estrogen is added as an adjuvant to progestin to address the specific symptoms of atrophic vaginitis, making it the correct choice. A: Dysfunctional uterine bleeding is typically treated with hormonal therapies targeting estrogen and progestin balance, not as an adjuvant. B: Menopausal syndrome is commonly treated with hormone replacement therapy, where estrogen is the primary drug, not an adjuvant. C: Osteoporosis treatment focuses on medications that help prevent bone loss and improve bone density, with estrogen not typically used as an adjuvant.