Adrenal Pathway Dysfunction

Question 1

adrenal cortex makes?

Answer 1

corticosteroids

mineralcorticoids, glucocorticoids, sex steroids

Question 2

steroid hormones are derived from

Answer 2

cholesterol

Question 3

actions of aldosterone include?

Answer 3

increases blood pressure
retains sodium
reduce potassium

Question 4

effect of ACTH on adrenals?

Answer 4

stimulates cortisol production

Question 5

cholesterol to aldosterone

Answer 5

cholesterol > pregnenolone > progesterone > deoxycorticosterone > aldosterone

Question 6

cholesterol to cortisol

Answer 6

cholesterol > pregnenolone (17-OH) > progesterone (17-OH) > cortisol

Question 7

cholesterol to oestrogen

Answer 7

cholesterol > pregnenolone > progesterone > androstenedione > testosterone > estradiol

Question 8

cortisol has what type of rhythm?

Answer 8

diurnal

Question 9

what is Addison’s disease?

Answer 9

primary adrenal failure

Question 10

two causes of addison’s

Answer 10

autoimmunity

TB

Question 11

Symptoms of addison’s

Answer 11

increased pigmentation 
vitiligo
low blood pressure
fatigue 
weight loss
hyperkalaemia

Question 12

consequences of adrenocortical failure

Answer 12

abdominal pains, vomiting, muscle weakness and fatigue, depression, low blood pressure, weight loss, kidney failure, changes in mood and personality, and shock (adrenal crisis)

Question 13

POMC is a precursor to

Answer 13

MSH

ACTH

Question 14

tests for addison’s

Answer 14

9am cortisol
blood test ACTH
+ve result low cortisol high ACTH
short synACTHen test measure cortisol response

Question 15

Replacement aldosterone is? why is it administered?

Answer 15

fludrocortisone
longer half life
makes it a once daily tablet

Question 16

Replacement cortisol is? Why?

Answer 16

prednisolone

mimics diurnal rhythm

Question 17

Commonest congenital adrenal hyperplasia caused by?

Answer 17

complete or partial 21 hydroxylase deficiency

Question 18

if a patient is deficient in 21 hydroxylase, what hormones are absent?

Answer 18

aldosterone and cortisol

Question 19

age of presentation of complete 21 hydroxylase deficiency

Answer 19

as a neonate salt losing addisonian crisis

girls may have ambiguous genitalia

Question 20

before birth foetus gets steroids from

Answer 20

across placenta

Question 21

with partial 21 hydroxylase deficiency what is the age of presentation?

Answer 21

any age as they survive

Question 22

main symptoms of partial 21 hydroxylase deficiency

Answer 22

hirsutism
virilisation in girls
precocious puberty in boys (adrenal testosterone)

Question 23

11 deoxycorticosone behaves like?

Answer 23

aldosterone

Question 24

11 deoxycorticosone in excess can cause?

Answer 24

hypertension

hypokalaemia

Question 25

with 11 hydroxylase deficiency which hormones are deficient and which in excess?

Answer 25

deficient: cortisol aldosterone
excess: sex steroids testosterone 11 deoxycorticosone

Question 26

with 17 hydroxylase deficiency, which hormones are deficient and which in excess?

Answer 26

deficient: cortisol, sex steroids
excess: aldosterone , 1 deoxycorticosone