Corticosteroids: adrenal suppression: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Corticosteroids: adrenal suppression

Sample item

Why should long-term high-dose prednisolone not be stopped abruptly?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Exogenous steroid suppresses the hypothalamic-pituitary-adrenal axis

Chronic glucocorticoid therapy suppresses ACTH and causes adrenal cortical atrophy. Abrupt withdrawal can precipitate adrenal insufficiency, so doses are tapered when clinically appropriate.

Option by option

  • A. It causes permanent mineralocorticoid receptor blockade

    Prednisolone is not a permanent mineralocorticoid antagonist.

  • B. It accumulates in bone marrow for months

    Bone-marrow accumulation does not explain withdrawal adrenal crisis.

  • C. Exogenous steroid suppresses the hypothalamic-pituitary-adrenal axis (correct)

    Correct. HPA-axis suppression makes cortisol production temporarily inadequate.

  • D. It irreversibly depletes adrenal catecholamines

    Catecholamine depletion is not the mechanism.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Exogenous steroid suppresses the hypothalamic-pituitary-adrenal axis. Chronic glucocorticoid therapy suppresses ACTH and causes adrenal cortical atrophy.

Why is "It causes permanent mineralocorticoid receptor blockade" not the answer?

Prednisolone is not a permanent mineralocorticoid antagonist.

Why is "It accumulates in bone marrow for months" not the answer?

Bone-marrow accumulation does not explain withdrawal adrenal crisis.

Why is "It irreversibly depletes adrenal catecholamines" not the answer?

Catecholamine depletion is not the mechanism.

What concept does this question test?

It tests Corticosteroids: adrenal suppression in Pharmacology. Abrupt withdrawal can precipitate adrenal insufficiency, so doses are tapered when clinically appropriate.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Corticosteroids: adrenal suppression?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.