Which adverse effect would be expected during therapy with leuprolide for a woman with endometriosis?

Correct Answer: D

Rationale: Leuprolide is a GnRH agonist commonly used to treat endometriosis by inducing a temporary menopause-like state. Hot flushes are a common adverse effect due to the sudden decrease in estrogen levels. This is the expected side effect as the drug suppresses ovarian function. Galactorrhea is unlikely as it is more associated with prolactin-related issues. Vaginal infections are not directly related to leuprolide therapy for endometriosis. Menorrhagia is also unlikely as leuprolide suppresses menstruation. Therefore, hot flushes are the correct adverse effect to expect during therapy.

Correct Answer: B

Rationale: Step 1: Identify the rapidly lethal hormone-related effects – likely thyroid storm. Step 2: Propranolol is a beta-blocker that helps control symptoms like tachycardia and hypertension in thyroid storm, making it crucial for immediate management. Step 3: Betamethasone (A) is a corticosteroid, not the first-line for thyroid storm. Potassium iodide (C) is used for thyroid blockade in radiation emergencies, not initial treatment. Propylthiouracil (D) is used for long-term management but not the initial control of symptoms.

Correct Answer: D

Rationale: The correct answer is D: Stimulation of thyroid peroxidase. In the patient's disease, a drug would likely be used to increase thyroid hormone production. Thyroid peroxidase plays a crucial role in thyroid hormone synthesis by catalyzing the iodination of tyrosine residues on thyroglobulin. By stimulating thyroid peroxidase activity, the drug can enhance thyroid hormone production. The other choices (A, B, C) are incorrect because inhibiting thyroid protease, topoisomerase I, or proteolysis of thyroglobulin would not directly impact thyroid hormone synthesis and, therefore, would not likely mediate the therapeutic effect in the patient's disease.

Correct Answer: A

Rationale: The correct answer is A: Hyponatremia. Glucocorticoids without salt-retaining activity do not cause sodium retention, leading to hyponatremia. This is due to their lack of mineralocorticoid effects. The other choices are incorrect because hypercalcemia (B) is associated with hyperparathyroidism or excessive vitamin D, hypokalemia (C) is linked to potassium-wasting diuretics or renal tubular acidosis, and hyperglycemia (D) can be caused by factors like diabetes or excessive carbohydrate intake.

Correct Answer: D

Rationale: The correct answer is D. Therapy typically suppresses the immune system, leading to a decrease in lymphocytes. Lymphocytes are a key component of the immune system, so a decrease is expected with therapy. Neutrophils are primary defenders against infections, so they would not decrease. Erythrocytes are red blood cells responsible for oxygen transport and their decrease would lead to anemia, not a typical therapy response. Basophils are involved in allergic reactions and inflammation, so an increase in basophils would not be a typical response to therapy.