Adrenal & Steroid hormones

Question 1

synthesis of progesterone

Answer 1

Cholesterol
[stAR//desmolase//cyp11a//p450]
prenenolone
progesterone

StaR step is the regulated one. it feeds cholesterol from outer to inner mitochondrial membrane. happens in adrenal cortex

Question 2

Testosterone synthesis

Answer 2

Progesterone
[17a-hydroxylase]
[c17-20 lyase]
Testosterone

Question 3

Estradiol Synthesis

Answer 3

Testosterone
[aromatase]
Estradiol

Question 4

Pituitary-Adrenal Feedback of Desmolase

Answer 4

ACTH activates desmolase to convert cholesterol to Progestin.

corticosteroids inhibit ACTH produciton (feedback inhibition)

Question 5

Aldosterone synthesis

Answer 5

progesterone
[21-hydroxylase]
[11-hydroxylase]
Aldosterone

Question 6

Cortisol synthesis

Answer 6

progesterone
[17-hydroxylase]
[21-hydroxylase]
[11-hydroxylase]
cortisol

Question 7

11-hydroxylase deficiency

Answer 7

1) Aldosterone NOT produced
2) Cortisol-like hormone IS produced (deoxycortiocsterone accumulates and acts as mineralocorticoid)
3) adrenal androgens overproduced (i.e. testosterone, etc!)

you get:
VIRILIZATION
HYPOKALEMIA

Question 8

21-hydroxylase deficiency

Answer 8

1) don’t get aldosterone (mineralocorticoids)
2) don’t get cortisol (gluco)
3) androgens overproduced

virilizaiton
salt craving
hyPERkalemia

Question 9

17-a-hydroxylase deficiency

Answer 9

1) you only get ALDOSTERONE (mineralocorticoid)
2) you don’t get Cortisol (glucocorticoid)
3) you don’t get androgens

Question 10

5a reductase deficiency

Answer 10

can’t convert T to DHT (prostate, testes, hair follicles, and adrenal glands)

eek intersex
ambiguous external genitalia
virilizaiton at puberty

Question 11

cushing syndrome

Answer 11

increased cortisol (usually due to people taking cortisol for disease like asthma)– excess glucocortiocids

Question 12

Cushing disease

Answer 12

Caused by ACTH-secreting anterior pituitary hormone

1) TRUNCAL obesity, moon face appearance
2) weak connective tissue and striae present
3) insulin antagonism– DM II can result

Question 13

licorice induced hypertension

Answer 13

cortisol
[11-hydroxysteroid DH (licorice inhibits this]
cortisone

Question 14

congenital adrenal hyperplasia

Answer 14

deficiency of 21-hydroxylase OR 11-hydroxylase

Elevated ACTH (because you aren’t making coritocsteroids// no aldosterone-mineralocorticoids or cortisol-glucocorticoids to feedback)

ELEVATED ANDROGENS!