[MCQs] The Quizzes about Chronic Conditions – Part 7 (20 test)

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Chronic Conditions-7

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Question 1

You have seen a 36-year-old man with elevated blood On one occasion, his blood pressure was 163/90 mm Hg, and on a second occasion, his blood pressure was 158/102 mm Hg. You have encouraged lifestyle modifications including weight loss using exercise and dietary changes. Despite some modest weight loss, at his current visit, his blood pressure is 166/92 mm Hg. Which of the following is the best treatment strategy at this point?

A	Use a thiazide diuretic
B	Use an ACE inhibitor
C	Use an angiotensin receptor blocker
D	Use a beta-blocker
E	Use a two drug combination of medications

Question 1 Explanation: 

The patient described above has stage 2 hypertension (systolic blood pressure greater or equal to 160 mm Hg, or diastolic blood pressure greater or equal to 90 mm Hg). Since lifestyle modifications have not helped, the next step is to institute drug therapy. JNC 7 guidelines state that in patients with stage 2 hypertension, two-drug combination therapy is indicated. The most common regimen would be a thiazide diuretic along with either an ACE inhibitor, ARB, beta-blocker, or calciumchannel blocker.

Question 2

You are examining a 40-year-old patient for the first time, and find her blood pressure to be 155/92 mm Which of the following physical exam- ination findings, if present, would indicate a secondary cause of hypertension?

A	A left-sided carotid bruit
B	Distended jugular veins
C	A precordial heave
D	Absence of a femoral pulse
E	Papilledema

Question 2 Explanation: 

When examining a hypertensive patient, the physician should be alert for signs of end-organ damage and possible causes of secondary hypertension. Signs of end-organ damage include arteriolar narrowing, hemorrhages, exudates or papilledema, carotid bruits or jugular venous distension, a loud second heart sound or precordial heave, arrhythmias, absent peripheral pulses, and peripheral edema, just to name a few. Signs suggestive of secondary hypertension include abdominal or flank masses (polycystic kidneys), absence of femoral pulses (coarctation of the aorta), tachycardia/flushing/diaphoresis (pheochromocytoma), abdominal bruits (renal artery stenosis), pigmented striae (Cushing’s syndrome), or an enlarged thyroid gland (hyperthyroidism).

Question 3

You have just diagnosed a 35-year-old man with He is otherwise healthy and has no complaints. Which of the following labora- tory tests is not indicated in the initial workup?

A	Hemoglobin and hematocrit
B	Potassium
C	A thyroid stimulating hormone level
D	Fasting glucose
E	A resting electrocardiogram

Question 3 Explanation: 

Baseline laboratory screening is important to assess for end-organ damage and identify patients at high risk for cardiovascular complications. The routine tests for a newly diagnosed hypertensive patient include: hemoglobin and hematocrit, potassium, creatinine, fasting glucose, calcium, a fasting lipid profile, urinalysis, and a resting electrocardiogram. Other tests are not indicated unless physical examination or history makes them likely to be positive.

Question 4

You are treating a 40-year-old man for He is not respond- ing well to a thiazide diuretic, and on further evaluation reports intermittent tachycardia, diaphoresis, and dizziness upon standing. Which of the follow- ing tests is most likely to help you evaluate these symptoms?

A	Chest x-ray
B	Captopril renal scan
C	Urinary metanephrines and vanillymandelic acid levels
D	Plasma renin activity levels
E	Echocardiogram

Question 4 Explanation: 

The patient described in the question has symptoms consistent with pheochromocytoma. The best test to rule this out is urinary metanephrines and vanillymandelic acid levels. A chest x-ray would be helpful if coarctation of the aorta were suspected. A captopril renal scan or renal magnetic resonance angiography would evaluate renal artery stenosis. Plasma renin activity levels would identify primary aldosteronism, and an echocardiogram would help to identify left ventricular hypertrophy or systolic dysfunction.

Question 5

You are treating a 61-year-old man for He is not respond- ing well to combination therapy with a thiazide diuretic and a beta-blocker. On physical examination, you note an abdominal bruit. Which of the follow- ing tests is most likely to help you evaluate him further?

A	Chest x-ray
B	Captopril renal scan
C	Urinary metanephrines and vanillymandelic acid levels
D	Aortic CT scan
E	Echocardiogram

Question 5 Explanation: 

The patient described in the question has physical examination findings consistent with renal artery stenosis. A captopril renal scan or renal magnetic resonance angiography would evaluate this. Urinary metanephrines and vanillymandelic acid levels would help rule out pheochromocytoma. A chest x-ray would be helpful if coarctation of the aorta were suspected. An aortic CT would help to or quantify an aortic aneurysm, and an echocardiogram would help to identify left ventricular hypertrophy or systolic dysfunction.

Question 6

You are counseling a 33-year-old obese woman with Which of the following interventions would lower her systolic blood pressure the most?

A	Weight loss amounting to 10% of her total body weight
B	Adopting a diet high in fruits, vegetables, and low fat dairy products
C	Restricting dietary sodium
D	Increasing physical activity at least 30 minutes a day, most days of the week
E	Limit alcohol consumption to no more than 1 drink per day

Question 6 Explanation: 

While all of the interventions listed in this question have the potential to lower systolic blood pressure, the DASH diet (described in the landmark study, Dietary Approaches to Stop Hypertension) has been shown to lower blood pressure the most. The diet is high in potassium, calcium, and magnesium. The study found that diets high in fruits and vegetables, with a reduced content of saturated and total fat can lower systolic blood pressure by 8–14 mm Hg. A 10% weight loss will lower blood pressure by 5–10 mm Hg. Sodium restriction will lower blood pressure 2–8 mm Hg. Regular aerobic activity is also beneficial, lowering blood pressure by 4–9 mm Hg, and limiting alcohol can lower systolic blood pressure by 2–4 mm Hg.

Question 7

Despite lifestyle changes, a 37-year-old patient of yours still has blood pressures above She has no other medical concerns, and no abnormal- ities on physical examination or initial laboratory evaluation. Which of the following medications is best as an initial first line monotherapy?

A	A thiazide diuretic
B	An ACE inhibitor
C	An angiotensin receptor blocker
D	A calcium-channel blocker
E	A beta-blocker

Question 7 Explanation: 

The ALLHAT study and a metaanalysis of more than 42 clinical trials has demonstrated that low-dose diuretics are the most effective first-line treatment for preventing the occurrence of cardiovascular morbidity and mortality. If there are no compelling reasons to start another medication, it should be the medication of first choice

Question 8

A 42-year-old male patient of yours presented to the emergency depart- ment with a After full recovery, he presents to your office for follow up. Assuming he has no other medical concerns, which of the following medica- tions is best to lower his blood pressure and prevent recurrent stroke?

A	An aldosterone antagonist
B	An ACE inhibitor
C	An angiotensin receptor blocker
D	A calcium-channel blocker
E	A beta-blocker

Question 8 Explanation: 

The PROGRESS study (Perindopril Protection against Recurrent Stroke Study) found that an ACE inhibitor and diuretic in combination are effective in preventing recurrent stroke

Question 9

A 55-year-old man comes to your office after not being seen by a physician in more than 10 He is found to be hypertensive, and his creatinine is found to be 2.3 mg/dL (H). Which medication is likely to be best to control his blood pressure and decrease the likelihood of progres- sion of his renal disease?

A	A thiazide diuretic
B	An ACE inhibitor
C	A calcium-channel blocker
D	A beta-blocker
E	An aldosterone antagonist

Question 9 Explanation: 

Several clinical trials have documented the benefit of ACE inhibitors in patients with hypertension and chronic kidney disease. Angiotension receptor blockers are also beneficial.

Question 10

You have diagnosed a 39-year-old woman with Lifestyle modifications helped reduce her blood pressure, but she was still above goal. You chose to start hydrochlorothiazide, 25 mg daily. This helped her blood pressure, but her blood pressure is still 142/94. Which of the following is the best approach to take in this situation?

A	Increase her hydrochlorothiazide to 50 mg per day
B	Change to a loop diuretic
C	Change to an ACE inhibitor
D	Change to a beta-blocker
E	Add an ACE inhibitor

Question 10 Explanation: 

According to JNC 7 guidelines, if the initial agent does not control blood pressure sufficiently, a second agent of a different class should be added. Keeping both agents at272 Family Medicine lower doses will decrease side effects. ACE inhibitors and diuretics work well together with a relatively low incidence of side effects.

Question 11

You are seeing a 49-year-old man with a known history of hypercho- lesterolemia and hypertension who has had recent complaints of chest He reports a chest pressure, described as “heaviness” in the subster- nal area. It is not associated with activity, but will occur intermittently throughout the day. Which of the following is the best way to describe what the patient is feeling?

A	Classic angina
B	Atypical angina
C	Anginal equivalent
D	Nonanginal pain
E	Atypical nonanginal pain

Question 11 Explanation: 

Atypical angina occurs when the patient experiences pain that has the quality and characteristics of angina, or occurs with exertion, but not both. For example, atypical angina may be a sense of heaviness not consistently related to exertion or relieved by rest, or it may be pain with an atypical character (sharp or stabbing) but predictably brought on by exercise and relieved by rest. Classic angina has both features. Anginal equivalent occurs when dyspnea is the sole or major manifestation. Nonanginal pain has neither the quality nor the precipitants of angina. “Atypical nonanginal pain” is not a term used to describe chest pain

Question 12

You are seeing a 36-year-old man complaining of shortness of He reports symptoms associated with activity and relieved by rest. He is otherwise healthy, takes no medications, and denies chest pain or pressure. Which of the following is the best way to describe what the patient is feeling?

A	Classic angina
B	Atypical angina
C	Anginal equivalent
D	Nonanginal pain
E	Atypical nonanginal pain

Question 12 Explanation: 

An aginal equivalent occurs when a patient has no chest pain, but has other symptoms of cardiac ischemia (e.g., dyspnea) that is predictably precipitated by exertion and relieved by rest. Atypical angina occurs when the patient experiences pain that has the quality and characteristics of angina, or occurs with exertion, but not both. Nonanginal pain has neither the quality nor the precipitants of angina. “Atypical nonanginal pain” is not a term used to describe chest pain

Question 13

You are seeing a 44-year-old woman with a known history of asthma who has had recent complaints of chest She reports a stabbing pain that seems to be worse with inspiration. It is not associated with activity, but will occur intermittently throughout the day. Which of the following is the best way to describe what the patient is feeling?

A	Classic angina
B	Atypical angina
C	Anginal equivalent
D	Nonanginal pain
E	Atypical nonanginal pain

Question 13 Explanation: 

Nonanginal pain has neither the quality nor the precipitating features of angina. Typical descriptive terms of nonanginal pain include “stabbing,” “shooting,” “knifelike,” “jabbing,” and “tingling.” Atypical angina occurs when the patient experiences pain that has the quality and characteristics of angina, or occurs with exertion, but not both. Anginal equivalent occurs when dyspnea is the sole or major manifestation. “Atypical nonanginal pain” is not a term used to describe chest pain.

Question 14

You are evaluating a 39-year-old otherwise healthy man with a fam- ily history of ischemic heart He describes chest pressure that radi- ates to his jaw when he walks up steps at work. You order an ECG in the office, shown below:

(Reproduced, with permission, from Ferry D. Basic Electrocardiography in Ten Days, 1st ed. New York: McGraw-Hill, 2001: 83.)

What is the test of choice to determine if his chest pain is due to cardiac ischemia?

A	Exercise treadmill test
B	Thallium exercise treadmill test
C	Stress echocardiogram
D	Persantine/thallium test
E	Dobutamine echocardiogram

Question 14 Explanation: 

The standard provocative test for ischemic heart disease is an exercise treadmill test. However, certain ECG abnormalities make the standard ETT unreadable. These include left ventricular hypertrophy with strain, left bundle branch block (shown in the question), and ST segment baseline abnormalities in the precordial leads. In this case, a thallium ETT is preferred, as long as the patient can exercise.

Question 15

You are caring for a 56-year-old man who presents to you for an eval- uation of chest You determine that an exercise treadmill test is neces- sary. The patient completes stage III of a Bruce protocol, achieves a heart rate of 136 beats per minute, and has an ST segment depression of 1 mm in the three inferior leads at a heart rate of 130 beats per minute. These changes lasted 2 minutes into recovery. Which of the following features is a poor prognostic sign for the patient?

A	Being unable to reach stage IV of a Bruce protocol
B	Failure to achieve a heart rate of 140 beats per minute
C	Onset of ST segment depression at a heart rate of 130 beats per minute
D	Having ST segment depression in multiple leads
E	Having ST segment depression lasting two minutes into recovery

Question 15 Explanation: 

Poor prognostic signs in an exercise treadmill test include failure to complete stage II of a Bruce protocol, failure to achieve a heart rate greater than 120 beats per minute (off beta-blockers), onset of ST segment depression at a heart rate less than 120 beats per minute, having ST segment depression greater than 2.0 mm, having ST segment depression lasting more than 6 minutes into recovery, poor systolic blood pressure response to exercise, angina or ventricular tachycardia with exercise, and ST segment depression in multiple leads.

Question 16

You are medically treating an 85-year-old woman with stable angina, and choose to use What is the most important consideration when using this medication?

A	Headache
B	Fatigue
C	Interactions with beta-blockers
D	Interactions with calcium-channel blockers
E	Development of tolerance

Question 16 Explanation: 

Tolerance is the most significant issue to consider when using nitrates for stable angina. Tolerance develops rapidly when long-acting nitrates are given. When using a patch, it is important to have intervals of 10–12 hours without the patch to retain the antianginal effect. Headache and fatigue may be important side effects, but are more of a nuisance than an important consideration. The medications can be used with beta-blockers and calcium-channel blockers.

Question 17

You have chosen to treat a 70-year-old man with ischemic heart dis- ease using a beta-blocker. What is the most appropriate endpoint for the use of beta-blockers in this case?

A	Use no more than the equivalent of 40 mg BID of propalolol
B	Use the amount necessary to achieve a blood pressure of 100/70 mmHg or less
C	Use the amount necessary to keep the heart rate between 50–60 beats per minute
D	Increase the dosage until fatigue limits use
E	Increase the amount until angina disappears

Question 17 Explanation: 

All beta-blockers, regardless of their selectivity, are equally effective in treating angina. About 20% of patients do not respond. The dose should be adjusted to achieve a heart rate of 50–60 beats per minute.

Question 18

You are seeing a 25-year-old man for a complete physical examina- tion. Evaluating his height and weight, you determine his body mass index (BMI) to be How would you classify this patient?

A	His BMI classifies him as being underweight
B	His BMI places him within the normal range
C	His BMI classifies him as being overweight
D	His BMI classifies him as obese
E	His BMI classifies him as morbidly obese

Question 18 Explanation: 

Family physicians should be familiar with the use of body mass indices as an indicator of obesity and subsequent health risks. The BMI is determined by dividing the patient’s weight in kilograms by the square of the height in meters. A BMI greater than 26 is classified as overweight. A BMI greater than 30 is considered obese, and a BMI greater than 40 is considered morbidly obese.

Question 19

A 33-year-old woman is seeing you for weight At 5 ft 6in tall and 230 lb, she reports a history of having difficulty with weight since her teenage years. She has tried several “fad” diets but seems to gain weight quickly when going off the diet. She takes oral contraceptives to “help regulate her period,” but the rest of her medical history is unremark- able. Her vital signs are within the normal range. On physical examination, she has moderate adult acne and mild facial hair growth. The rest of her examination is unremarkable. Which of the following is the most likely secondary cause contributing to her obesity?

A	Polycystic ovary syndrome
B	Cushing syndrome
C	Hypogonadism
D	Hypothyroidism
E	Hypopituitary syndrome

Question 19 Explanation: 

Secondary causes of obesity are rare, but should be considered in the differential diagnosis for obesity. All of the answers to the question are possible secondary causes; but given the patient’s irregular menstrual periods, acne, and hirsuitism, polycystic ovary syndrome is more likely

Question 20

You are discussing weight management with an obese 33-year-old male In an effort to help motivate him to lose weight, you choose to bring up some health complications of obesity. Obesity increases the risk of developing which of the following diseases?

A	Hypothyroidism
B	Arthritis
C	Cushing’s disease
D	Asthma
E	Osteoporosis

Question 20 Explanation: 

There are several well-known health complications of obesity. They include hypertension, diabetes, cancers (most notably breast cancer), dyslipidemias, arthritis, depression, cholelithiasis, coronary artery disease, and sleep apnea among others. Hypothyroidism and Cushing’s disease may be secondary causes of obesity, but are not274 Family Medicine consequences of obesity. Asthma has not been linked to obesity, but the lack of exercise in some patients with asthma may predispose persons to becoming overweight. Osteoporosis risk is not increased in obese people.

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II. Preview all questions below

1. You have seen a 36-year-old man with elevated blood On one occasion, his blood pressure was 163/90 mm Hg, and on a second occasion, his blood pressure was 158/102 mm Hg. You have encouraged lifestyle modifications including weight loss using exercise and dietary changes. Despite some modest weight loss, at his current visit, his blood pressure is 166/92 mm Hg. Which of the following is the best treatment strategy at this point?

1. Use a thiazide diuretic
2. Use an ACE inhibitor
3. Use an angiotensin receptor blocker
4. Use a beta-blocker
5. Use a two drug combination of medications

2. You are examining a 40-year-old patient for the first time, and find her blood pressure to be 155/92 mm Which of the following physical exam- ination findings, if present, would indicate a secondary cause of hypertension?

1. A left-sided carotid bruit
2. Distended jugular veins
3. A precordial heave
4. Absence of a femoral pulse
5. Papilledema

3. You have just diagnosed a 35-year-old man with He is otherwise healthy and has no complaints. Which of the following labora- tory tests is not indicated in the initial workup?

1. Hemoglobin and hematocrit
2. Potassium
3. A thyroid stimulating hormone level
4. Fasting glucose
5. A resting electrocardiogram

4. You are treating a 40-year-old man for He is not respond- ing well to a thiazide diuretic, and on further evaluation reports intermittent tachycardia, diaphoresis, and dizziness upon standing. Which of the follow- ing tests is most likely to help you evaluate these symptoms?

1. Chest x-ray
2. Captopril renal scan
3. Urinary metanephrines and vanillymandelic acid levels
4. Plasma renin activity levels
5. Echocardiogram

5. You are treating a 61-year-old man for He is not respond- ing well to combination therapy with a thiazide diuretic and a beta-blocker. On physical examination, you note an abdominal bruit. Which of the follow- ing tests is most likely to help you evaluate him further?

1. Chest x-ray
2. Captopril renal scan
3. Urinary metanephrines and vanillymandelic acid levels
4. Aortic CT scan
5. Echocardiogram

6. You are counseling a 33-year-old obese woman with Which of the following interventions would lower her systolic blood pressure the most?

1. Weight loss amounting to 10% of her total body weight
2. Adopting a diet high in fruits, vegetables, and low fat dairy products
3. Restricting dietary sodium
4. Increasing physical activity at least 30 minutes a day, most days of the week
5. Limit alcohol consumption to no more than 1 drink per day

7. Despite lifestyle changes, a 37-year-old patient of yours still has blood pressures above She has no other medical concerns, and no abnormal- ities on physical examination or initial laboratory evaluation. Which of the following medications is best as an initial first line monotherapy?

1. A thiazide diuretic
2. An ACE inhibitor
3. An angiotensin receptor blocker
4. A calcium-channel blocker
5. A beta-blocker

8. A 42-year-old male patient of yours presented to the emergency depart- ment with a After full recovery, he presents to your office for follow up. Assuming he has no other medical concerns, which of the following medica- tions is best to lower his blood pressure and prevent recurrent stroke?

1. An aldosterone antagonist
2. An ACE inhibitor
3. An angiotensin receptor blocker
4. A calcium-channel blocker
5. A beta-blocker

9. A 55-year-old man comes to your office after not being seen by a physician in more than 10 He is found to be hypertensive, and his creatinine is found to be 2.3 mg/dL (H). Which medication is likely to be best to control his blood pressure and decrease the likelihood of progres- sion of his renal disease?

1. A thiazide diuretic
2. An ACE inhibitor
3. A calcium-channel blocker
4. A beta-blocker
5. An aldosterone antagonist

10. You have diagnosed a 39-year-old woman with Lifestyle modifications helped reduce her blood pressure, but she was still above goal.

You chose to start hydrochlorothiazide, 25 mg daily. This helped her blood pressure, but her blood pressure is still 142/94. Which of the following is the best approach to take in this situation?

1. Increase her hydrochlorothiazide to 50 mg per day
2. Change to a loop diuretic
3. Change to an ACE inhibitor
4. Change to a beta-blocker
5. Add an ACE inhibitor

11. You are seeing a 49-year-old man with a known history of hypercho- lesterolemia and hypertension who has had recent complaints of chest He reports a chest pressure, described as “heaviness” in the subster- nal area. It is not associated with activity, but will occur intermittently throughout the day. Which of the following is the best way to describe what the patient is feeling?

1. Classic angina
2. Atypical angina
3. Anginal equivalent
4. Nonanginal pain
5. Atypical nonanginal pain

12. You are seeing a 36-year-old man complaining of shortness of He reports symptoms associated with activity and relieved by rest. He is otherwise healthy, takes no medications, and denies chest pain or pressure. Which of the following is the best way to describe what the patient is feeling?

1. Classic angina
2. Atypical angina
3. Anginal equivalent
4. Nonanginal pain
5. Atypical nonanginal pain

13. You are seeing a 44-year-old woman with a known history of asthma who has had recent complaints of chest She reports a stabbing pain that seems to be worse with inspiration. It is not associated with activity, but will occur intermittently throughout the day. Which of the following is the best way to describe what the patient is feeling?

1. Classic angina
2. Atypical angina
3. Anginal equivalent
4. Nonanginal pain
5. Atypical nonanginal pain

14. You are evaluating a 39-year-old otherwise healthy man with a fam- ily history of ischemic heart He describes chest pressure that radi- ates to his jaw when he walks up steps at work. You order an ECG in the office, shown below:

(Reproduced, with permission, from Ferry D. Basic Electrocardiography in Ten Days, 1st ed. New York: McGraw-Hill, 2001: 83.)

What is the test of choice to determine if his chest pain is due to cardiac ischemia?

1. Exercise treadmill test
2. Thallium exercise treadmill test
3. Stress echocardiogram
4. Persantine/thallium test
5. Dobutamine echocardiogram

15. You are caring for a 56-year-old man who presents to you for an eval- uation of chest You determine that an exercise treadmill test is neces- sary. The patient completes stage III of a Bruce protocol, achieves a heart rate of 136 beats per minute, and has an ST segment depression of 1 mm in the three inferior leads at a heart rate of 130 beats per minute. These changes lasted 2 minutes into recovery. Which of the following features is a poor prognostic sign for the patient?

1. Being unable to reach stage IV of a Bruce protocol
2. Failure to achieve a heart rate of 140 beats per minute
3. Onset of ST segment depression at a heart rate of 130 beats per minute
4. Having ST segment depression in multiple leads
5. Having ST segment depression lasting two minutes into recovery

16. You are medically treating an 85-year-old woman with stable angina, and choose to use What is the most important consideration when using this medication?

1. Headache
2. Fatigue
3. Interactions with beta-blockers
4. Interactions with calcium-channel blockers
5. Development of tolerance

17. You have chosen to treat a 70-year-old man with ischemic heart dis- ease using a beta-blocker. What is the most appropriate endpoint for the use of beta-blockers in this case?

1. Use no more than the equivalent of 40 mg BID of propalolol
2. Use the amount necessary to achieve a blood pressure of 100/70 mmHg or less
3. Use the amount necessary to keep the heart rate between 50–60 beats per minute
4. Increase the dosage until fatigue limits use
5. Increase the amount until angina disappears

18. You are seeing a 25-year-old man for a complete physical examina- tion. Evaluating his height and weight, you determine his body mass index (BMI) to be How would you classify this patient?

1. His BMI classifies him as being underweight
2. His BMI places him within the normal range
3. His BMI classifies him as being overweight
4. His BMI classifies him as obese
5. His BMI classifies him as morbidly obese

19. A 33-year-old woman is seeing you for weight At 5 ft 6in tall and 230 lb, she reports a history of having difficulty with weight since her teenage years. She has tried several “fad” diets but seems to gain weight quickly when going off the diet. She takes oral contraceptives to “help regulate her period,” but the rest of her medical history is unremark- able. Her vital signs are within the normal range. On physical examination, she has moderate adult acne and mild facial hair growth. The rest of her examination is unremarkable. Which of the following is the most likely secondary cause contributing to her obesity?

1. Polycystic ovary syndrome
2. Cushing syndrome
3. Hypogonadism
4. Hypothyroidism
5. Hypopituitary syndrome

20. You are discussing weight management with an obese 33-year-old male In an effort to help motivate him to lose weight, you choose to bring up some health complications of obesity. Obesity increases the risk of developing which of the following diseases?

1. Hypothyroidism
2. Arthritis
3. Cushing’s disease
4. Asthma
5. Osteoporosis