Endocrine pharmacology questions.
Endocrine pharmacology rewards a single habit: ask what the hormone normally does, then ask whether the drug is adding to it or blocking it. Most of the side effects follow from that answer without needing to be learned separately.
Commit to an answer before you reveal it. Every explanation says why the right option is right, not merely which one it is, since a reason is what transfers to the next question and a fact is not.
Q1 Metformin rarely causes hypoglycaemia alone because it…
Answer: Lowers hepatic glucose output without insulin release
Hypoglycaemia requires insulin to be pushed higher than the glucose load justifies. Metformin does not touch insulin secretion at all; it reduces hepatic gluconeogenesis and improves peripheral sensitivity, so counter-regulation stays intact and glucose does not overshoot downwards.
Q2 Sulfonylureas cause hypoglycaemia and weight gain because they…
Answer: Close K-ATP channels, releasing insulin regardless
By closing the K-ATP channel directly, sulfonylureas depolarise the beta cell and trigger insulin release whether or not glucose is elevated. That is precisely the mechanism causing hypoglycaemia, and because insulin is anabolic, the same unearned insulin drives weight gain.
Q3 A beta blocker is risky in an insulin-treated diabetic because it…
Answer: Masks the adrenergic warning signs of a low glucose
The early symptoms of a falling glucose, tremor and palpitations, are sympathetic responses mediated by beta receptors, so blocking them removes the warning without removing the danger. Sweating is cholinergic and usually persists, making it the one symptom that may appear.
Q4 Levothyroxine should be taken on an empty stomach because…
Answer: Calcium, iron and food reduce its absorption
Levothyroxine absorption is easily impaired, and calcium and iron supplements in particular bind it in the gut. Because the therapeutic margin is judged by a sensitive TSH measurement, a modest and inconsistent change in absorption makes dose titration unreliable.
Q5 Long-term corticosteroids must not be stopped abruptly because…
Answer: HPA suppression leaves no cortisol response available
Exogenous steroid suppresses ACTH, and prolonged suppression causes the adrenal cortex to atrophy. Removing the drug leaves the patient with neither the tablet nor a gland capable of responding, which is why a taper lets the axis recover before support is withdrawn.
Q6 Dexamethasone is preferred where fluid retention must be avoided because it…
Answer: Has negligible mineralocorticoid activity
Glucocorticoid and mineralocorticoid potency vary independently across the steroids. Hydrocortisone has substantial mineralocorticoid activity and causes sodium and water retention, while dexamethasone is a far more potent glucocorticoid with almost none.
Q7 SGLT2 inhibitors predispose to genital thrush because they…
Answer: Raise urinary glucose, which feeds yeast
These drugs work by preventing glucose reabsorption in the proximal tubule, so glucose is deliberately lost in the urine. The therapeutic mechanism and the side effect are the same event: sugar in the urine lowers blood glucose and simultaneously feeds yeast in the genital area.
Q8 Nausea with GLP-1 receptor agonists is explained by…
Answer: Delayed gastric emptying and central appetite effects
GLP-1 agonists reproduce an incretin signal that slows gastric emptying and reduces appetite centrally, and those two effects are inseparable from the weight loss they produce. Nausea is therefore a consequence of the mechanism working, which is why escalation is gradual.
Q9 A patient starting carbimazole should be told to report…
Answer: A sore throat or fever, suggesting agranulocytosis
Agranulocytosis is rare but can develop rapidly, and the patient has no way of detecting a falling neutrophil count except through the infection it permits. A sore throat is the usual first sign, so the counselling point converts an invisible event into something actionable.
Q10 Metformin is cautioned in significant renal impairment because…
Answer: Accumulation raises the risk of lactic acidosis
Metformin is cleared unchanged by the kidney, so failing renal function lets it accumulate. Because the drug shifts metabolism towards lactate production, high concentrations raise the risk of lactic acidosis, which is rare but carries high mortality when it occurs.
Pick an answer to check it. Nothing is saved, and you can reset the set at any time.
Where to take this next
A set answered once shows you where the gaps are. Closing them takes repetition spaced over weeks, with the misses returning more often than the hits, which is what spaced repetition in the app is for. In the meantime these go deeper on the mechanisms behind the questions above.
- CYP450 inducers and inhibitors
- Drug name stems, decoded
- Corticosteroid equivalence calculator — free calculator with a worked example
- Creatinine clearance calculator (Cockcroft-Gault) — free calculator with a worked example
Other practice sets
Cardiovascular · Antimicrobials · Autonomic · Pharmacokinetics · CNS drugs · All practice questions
If you are working towards a named licensing exam, the exam preparation hub shows which of these topics your board weights most heavily.
Study aid only. These questions are written for learning and examination practice. They are not medical advice, not clinical decision support, and must never be used to make a decision about a real patient. Always verify against your local formulary, the product literature and a qualified pharmacist. See our medical disclaimer.
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