<prompt> Which one of the following is the true statement regarding adrenal suppression secondary to steroid therapy?It is not associated with atrophy of the adrenal glandsIt does not occur in patients receiving inhaled steroidsIt should be expected in anyone receiving 5mg, Prednisolone dailyFollowing cessation, the stress response normalizes after 8 weeks  <response>: Supression of hypothalamo pituitary axis occur depending on the dose and duration of therapy. It occurs when hydrocoisone 20-25mgday or equivalent is given for more than 2-3weeks. Prednisolone is 5 times more potent than hydrocoisone and therefore 5 mg prednisone is equivalent to 25 mg Hydrocoisone. Thus, suppression of HPA should be expected in any patient who has received 5mg prednisoloneday for more than 2- 3 weeks. With the administration of steroids adrenal coex atrophies, and stoppage of exogenous steroid can precipitate a withdrawal syndrome. Withdrawal syndrome is characterized by fever, malaise, weakness, pain in muscles and joints, and reactivation of the disease. When subjected to stress these patients undergo acute adrenal insufficiency. Ref: Essentials of Medical Pharmacology, 5th Edition, Page 265; Pharmaceutical Innovation: Revolutionizing Human Health By Ralph Landau, Page 245; Asthma Care in the Community By Jill Waldro, Page 58 