Endocrine drugs: alternate-day glucocorticoid: 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 · Endocrine drugs: alternate-day glucocorticoid

Sample item

A 7-year-old with steroid-dependent nephrotic syndrome on daily prednisolone has slowed growth and cushingoid features. Which change reduces growth suppression and adrenal suppression while keeping control?

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

The answer and the reasoning

C. Switch to a single morning dose on alternate days

Alternate-day morning dosing with an intermediate-acting steroid such as prednisolone allows the axis and growth plates a steroid-free day, lowering suppression of growth and the adrenal axis for the same overall control.

Option by option

  • A. Add fludrocortisone for growth

    Fludrocortisone has no role in promoting growth.

  • B. Give the whole daily dose at midnight

    A midnight dose would suppress the early-morning ACTH surge and worsen axis suppression.

  • C. Switch to a single morning dose on alternate days (correct)

    Correct. A single morning dose on alternate days lessens growth and axis suppression.

  • D. Change to dexamethasone, which suppresses growth less

    Dexamethasone is long-acting and potent, and suppresses growth more.

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, Switch to a single morning dose on alternate days. Alternate-day morning dosing with an intermediate-acting steroid such as prednisolone allows the axis and growth plates a steroid-free day, lowering suppression of growth and the adrenal axis for the same overall control.

Why is "Add fludrocortisone for growth" not the answer?

Fludrocortisone has no role in promoting growth.

Why is "Give the whole daily dose at midnight" not the answer?

A midnight dose would suppress the early-morning ACTH surge and worsen axis suppression.

Why is "Change to dexamethasone, which suppresses growth less" not the answer?

Dexamethasone is long-acting and potent, and suppresses growth more.

What concept does this question test?

It tests Endocrine drugs: alternate-day glucocorticoid in Pharmacology. The correct option holds because: Correct. A single morning dose on alternate days lessens growth and axis suppression.

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 Endocrine drugs: alternate-day glucocorticoid?

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.