Corticoid Therapy

Question 1

What is the rate limiting step of all Steroid production?

Answer 1

Pregnolone

Question 2

What enzyme is involved in the final step of Aldosterone production? What is its substrate?

Answer 2

Corticosterone -> Aldosterone via 18-Hydroxylase

Question 3

Where are Glucorticoids produced in the Adrenal Glands?

Answer 3

Zona Fasciculata

Question 4

Cholesterol is converted to Pregnolone by what enzyme?

Answer 4

Cholesterol desmolase (Cholesterol side-chain cleavage enzyme)

Question 5

If a patient has 18-Hydroxlase defiency, what effect will that have?

Answer 5

Reduced aldosterone production

Question 6

What is the most common cause of Congenital Adrenal Hyperplasia?

Answer 6

21-Hydroxylase deficiency

Question 7

What is the substrate for 21-Hydroxylase?

Answer 7

Progesterone

Question 8

How do Glucorticoids direct a Cellular response?

Answer 8

They are nuclear receptors, which can diffuse across cell membranes into cell nuclei and upregulate anti-inflammatory genes and downregulate pro-inflammatory genes

Question 9

What are some unwanted effects of Inhaled Gluco-corticosteroids?

Answer 9

Can cause opportunistic overgrowth of Candida (thrush)

Can effect vocal cords (dysphonia)

Question 10

What is Conn’s syndrome? What is it caused by?

Answer 10

Primary Aldosteronism, caused an adrenal adenoma or adrenal tumour

Question 11

Most steroid drugs target the Glucocorticoid receptor > Mineralcorticoid receptor. What are the exceptions?

Answer 11

Hydrocortisone: Binds to GR and MR equally

Fludrocortisone: Binds to MR > GR