Cortisol Quiz
Questions: 16 · 10 minutes
1. After taking a prescribed glucocorticoid for several months, someone feels better and wants to stop it immediately. What is the safest general response?
Skip every other dose without seeking medical guidance
Move the entire dose to bedtime before stopping the next day
Contact the prescriber because abrupt withdrawal can be dangerous and a supervised taper may be needed
Replace the medicine with an over-the-counter cortisol supplement
2. Which group of symptoms is more consistent with possible adrenal insufficiency than with cortisol excess?
Easy bruising, facial rounding, and wide purple stretch marks
Persistent high blood pressure, muscle weakness, and central weight gain
Heat intolerance, tremor, rapid heartbeat, and increased appetite
Fatigue, weight loss, nausea, and low blood pressure
3. A patient taking oral estrogen has a higher total serum cortisol result but no clear symptoms of cortisol excess. What may help explain this?
Oral estrogen can increase cortisol-binding globulin and raise measured total cortisol
Estrogen permanently converts cortisol into ACTH
Oral estrogen prevents all cortisol from entering the bloodstream
Estrogen makes the adrenal glands stop responding to ACTH in every patient
4. For a person with a regular daytime schedule, which cortisol pattern is generally expected?
It stays nearly constant throughout the day and night
It is relatively high around waking and falls toward its nighttime low
It is lowest after waking and peaks immediately before sleep
It alternates between high and low levels every few hours without a daily pattern
5. Someone has fatigue, poor sleep, and recent weight changes and assumes that high cortisol must be the cause. What is the most accurate response?
That combination establishes high cortisol even without laboratory testing
Those symptoms are nonspecific and cannot confirm a cortisol disorder without appropriate evaluation
Those symptoms occur only when cortisol is lower than normal
A single home blood-pressure reading can confirm whether cortisol is responsible
6. A clinician orders late-night salivary cortisol when evaluating possible cortisol excess. What feature is this test designed to assess?
Whether the kidneys release cortisol in response to dehydration
Whether the thyroid produces enough hormone during sleep
Whether cortisol remains inappropriately high when it should be near its nighttime low
Whether cortisol rises normally immediately after exercise
7. A person who is not using glucocorticoid medication has repeatedly high cortisol and low ACTH. Which interpretation best fits that pattern?
Primary adrenal failure causing inadequate cortisol production
An ACTH-producing pituitary source driving both hormones upward
Cortisol production that is relatively independent of pituitary ACTH, potentially from an adrenal source
A typical pattern that rules out an endocrine disorder
8. What does a 24-hour urinary free cortisol test mainly estimate?
The exact cortisol concentration at the moment the collection ends
Only the amount of ACTH released by the pituitary overnight
The adrenal glands’ size and physical structure
The amount of unbound cortisol excreted in urine across a full day
9. A person with known adrenal insufficiency develops repeated vomiting, severe weakness, abdominal pain, confusion, and faintness. What should happen next?
Seek urgent medical help because these can be signs of an adrenal crisis
Drink a caffeinated beverage and continue normal activities
Skip prescribed adrenal medication until the vomiting resolves
Wait until the next routine appointment to mention the symptoms
10. Which laboratory pattern is commonly associated with untreated primary adrenal insufficiency, also called Addison disease?
High cortisol with low ACTH
High cortisol with high ACTH
Low cortisol with elevated ACTH
Low cortisol with suppressed thyroid-stimulating hormone in every case
11. Which cluster can occur with prolonged cortisol excess and would justify medical evaluation?
Easy bruising, muscle weakness, wide purple stretch marks, and central weight gain
Weight loss, salt craving, low blood pressure, and skin darkening
Neck swelling, cold intolerance, slowed pulse, and coarse hair
Excessive thirst, frequent urination, fruity breath, and rapid breathing
12. During an acute stress response, which change is most directly supported by cortisol?
A rapid reduction in available blood glucose
Greater availability of energy, including glucose, to meet demand
A sharp fall in blood pressure to conserve energy
Immediate production of antibodies against infection
13. A blood cortisol result is elevated after a stressful, sleepless morning. What is the best interpretation?
It proves an adrenal tumor is producing cortisol
It confirms chronic cortisol excess regardless of collection time
It can be ignored because stress never affects cortisol testing
It needs context because timing, acute stress, illness, and medications can affect the result
14. Which sequence correctly describes the main hormonal pathway that stimulates cortisol production?
Hypothalamus releases CRH → pituitary releases ACTH → adrenal cortex releases cortisol
Pituitary releases CRH → adrenal gland releases ACTH → hypothalamus releases cortisol
Adrenal cortex releases CRH → hypothalamus releases ACTH → pituitary releases cortisol
Hypothalamus releases cortisol → adrenal cortex releases CRH → pituitary releases ACTH
15. Where is cortisol primarily produced?
In the pancreas, alongside insulin
In the thyroid gland at the front of the neck
In the pituitary gland at the base of the brain
In the adrenal cortex, within glands located above the kidneys
16. A person develops features of Cushing syndrome after months of treatment for an inflammatory condition. Which cause should be considered?
Short-term use of a nonsteroidal anti-inflammatory medicine
Prolonged use of a glucocorticoid medicine such as prednisone
An isolated night of poor sleep
Insufficient dietary vitamin C