1. Amiloride
2. Oestrogen
3. Finasteride
4. Spironolactone
Select the correct answer using the code given below :
Treatment of Hirsutism
Hirsutism results from excess androgen action on hair follicles, most commonly due to conditions like PCOS. Pharmacological management is aimed at suppressing androgen production, blocking androgen receptors, or inhibiting peripheral androgen activation. The correct answer is Option C (2, 3 and 4) — Oestrogen, Finasteride and Spironolactone.
Analysis of Each Option
- 1. Amiloride: This is a potassium-sparing diuretic that acts on the renal collecting duct sodium channel. It has no established role in the hormonal management of hirsutism and does not affect androgen synthesis, metabolism, or receptor action. It is therefore not included among the correct statements.
- 2. Oestrogen: Oestrogen, typically given as part of a combined oral contraceptive pill, increases hepatic synthesis of Sex Hormone Binding Globulin (SHBG). Higher SHBG binds more circulating free testosterone, lowering the biologically active (free) androgen fraction available to hair follicles. COCPs are a first-line therapy for hirsutism in women who also desire contraception, making oestrogen a useful and correct component of treatment.
- 3. Finasteride: Finasteride is a 5α-reductase inhibitor that blocks the peripheral conversion of testosterone to the more potent dihydrotestosterone (DHT), the androgen chiefly responsible for hair follicle stimulation. By lowering DHT levels at the follicle, it reduces terminal hair growth, confirming it as a useful agent.
- 4. Spironolactone: Spironolactone is an aldosterone antagonist that also acts as a competitive androgen receptor blocker, and at higher doses mildly inhibits androgen synthesis. It is one of the most commonly used anti-androgens for hirsutism, particularly in combination with a COCP, confirming it as useful.
Conclusion
Among the four agents listed, Oestrogen, Finasteride, and Spironolactone (2, 3 and 4) all have recognized, mechanism-based roles in reducing androgen effect and are used in the treatment of hirsutism, whereas Amiloride has no such role. Hence, Option C is the correct answer.
Important Questions from Adrenal Disorders
- Which one of the following is a cause of Secondary Hyperaldosteronism?
Which of the following are correct regarding Cortisol?
1. Levels are highest in the morning on waking.
2. Cortisol falls dramatically during an illness.
3. More than 95% circulating cortisol is protein bound.
4. It is the major glucocorticoid in humans and can also activate mineralocorticoid receptors.
Select the answer using the code given below :
- A 50-year lady, who is a known case of rheumatoid arthritis, presents with obesity, moon facies, abdominal striae and hypertension. Overnight dexamethasone suppression test shows serum cortisol is greater than 50 nmol/L, serum ACTH is less than 1.1 pmol/L. The adrenal imaging and brain CT/MRI imaging studies are unremarkable. The likely diagnosis is
- Hirsutism is seen in which of the following ?
1. Polycystic ovarian syndrome
2. Congenital adrenal hyperplasia
3. Hypothyroidism
4. Ovarian tumour
Select the correct answer using the code given below: - A patient presents with circulatory shock, nausea, vomiting and diarrhoea. A diagnosis of acute adrenal crisis is considered. A blood sample is stored for measurement of serum cortisol and treatment started without delay. Which of the following are appropriate interventions?
1. IV normal saline
2. IV hydrocortisone 100 mg stat
3. IV 10% glucose
4. IV KCl as infusion
Select the correct answer using the code given below:
