Adrenal Insufficiency MCQ Quiz | Endocrinology & Metabolism

Welcome to the Endocrinology & Metabolism quiz on Adrenal Insufficiency, specifically designed for MBBS students. This quiz will test your understanding of the pathophysiology, clinical presentation, diagnosis, and management of primary, secondary, and tertiary adrenal insufficiency, including the life-threatening adrenal crisis. You will encounter 25 multiple-choice questions covering key concepts such as Addison’s disease, ACTH stimulation tests, and replacement therapies. After submitting your answers, you will receive your score and a detailed review of the correct and incorrect responses. For your future revision, a comprehensive list of all questions with their correct answers is available for download as a PDF. Challenge yourself and solidify your knowledge on this critical endocrine disorder.

1. What is the most common cause of primary adrenal insufficiency (Addison’s disease) in developed countries?

2. A patient with primary adrenal insufficiency presents with hyperpigmentation. This is caused by the overproduction of which hormone’s precursor?

3. Which set of electrolyte abnormalities is classic for primary adrenal insufficiency?

4. The definitive diagnostic test for adrenal insufficiency is:

5. Which clinical feature is typically absent in secondary adrenal insufficiency compared to primary?

6. What is the most critical and immediate step in the management of a patient in an adrenal crisis?

7. What is the most frequent cause of secondary adrenal insufficiency?

8. In a patient with primary adrenal insufficiency (Addison’s disease), what are the expected levels of cortisol and ACTH?

9. Mineralocorticoid replacement with fludrocortisone is essential in primary adrenal insufficiency but often unnecessary in secondary adrenal insufficiency. Why?

10. What is the standard oral glucocorticoid replacement therapy for chronic adrenal insufficiency, typically given in divided doses?

11. Waterhouse-Friderichsen syndrome is a catastrophic form of adrenal insufficiency caused by:

12. Which instruction regarding “sick day rules” is crucial for patients with adrenal insufficiency?

13. A common metabolic finding in an acute adrenal crisis, especially in children, is:

14. Tertiary adrenal insufficiency is caused by a disorder of the:

15. The CRH stimulation test is primarily used to differentiate between:

16. Which of these drugs is an adrenal steroidogenesis inhibitor that can precipitate adrenal insufficiency?

17. In secondary adrenal insufficiency, what are the expected levels of cortisol and ACTH?

18. The Insulin Tolerance Test (ITT) is considered a gold standard for assessing the HPA axis but is rarely used due to risks. What is a major contraindication for ITT?

19. How is the adequacy of mineralocorticoid (fludrocortisone) replacement therapy primarily monitored?

20. Congenital Adrenal Hyperplasia (CAH), most commonly due to 21-hydroxylase deficiency, can present with adrenal insufficiency. What is a typical presentation in neonates?

21. Autoimmune Polyglandular Syndrome Type 2 (Schmidt’s syndrome) is characterized by Addison’s disease in combination with which other conditions?

22. A patient with known adrenal insufficiency is scheduled for major surgery. What is the appropriate perioperative management of their glucocorticoid therapy?

23. In the standard short ACTH stimulation test (250 mcg), what cortisol response is considered normal, thus ruling out primary adrenal insufficiency?

24. What is the primary role of DHEA supplementation in women with adrenal insufficiency?

25. A patient on long-term steroid therapy for an autoimmune disease suddenly stops their medication. They are at high risk for which condition?