Endocrine

Question 0

What are the hormone imbalances in 21 hydroxylase deficiency?

Answer 0

1. Decreased cortisol
2. Decreased aldosterone
3. Increased sex steroids

Question 1

What is the most common cause of congenital adrenal hyperplasia?

Answer 1

21 hydroxylase deficiency

Question 2

How does decreased aldosterone in CAH manifest?

Answer 2

Hyperkalemia, salt wasting, hypovolemia

Question 3

What is the difference between 21 hydroxylase and 11 beta hydroxylase deficiency?

Answer 3

Both have decreased cortisol and aldosterone, and increased sex hormones, but in 11 deficiency you have production of a weak mineralocorticoid that -> no salt wasting, no hyperkalemia, and no volume depletion. 11 deficiency -> hypertension vs. 21 deficiency -> hypotension

Question 4

What do all 3 causes of CAH have in common?

Answer 4

Decreased cortisol production → increased ACTH → adrenal hyperplasia

Question 5

What are the hormonal abnormalities on 17 alpha hydroxylase deficiency?

Answer 5

↑↑ aldosterone, ↓ cortisol, ↓ sex hormones

Question 6

What disease is characterized by chronic adrenal insufficiency? What are 3 main causes?

Answer 6

Addison disease

1. Autoimmune (most common in west)
2. TB (most common in dev. Countries)
3. Metastasis

Question 7

Why does Addison disease → hyperpigmentation?

Answer 7

↓ cortisol → ↑ ACTH production from POMC (opiomelanocortin) → ↑ MSH byproduct

Question 8

How can primary adrenal insufficiency be distinguished clinically from secondary (↓ ACTH)?

Answer 8

2ndary has no hyperpigmentation and no hyperkalemia

Question 9

What are the hormonal abnormalities in Addison disease?

Answer 9

↓ aldosterone and ↓ cotisol