Primer 29 Adrenal Steroid Synthesis

Question 1

From which structure is derived the medulla?

Answer 1

Medulla derived from Neural Crest.

Question 2

Which are the layers from the adrenal cortex?

Answer 2

1) zona Glomerulosa.
2) zona Fasciculata.
3) zona Reticularis. “GFR”

Question 3

Which product is secreted by adrenal cortex in his zona Glomerulosa?

Answer 3

Aldosterone.

Question 4

Which product is secreted by adrenal cortex in his zona Fasciculata?

Answer 4

Cortisol.

Question 5

Which product is secreted by adrenal cortex in his zona Reticularis?

Answer 5

Sex hormone.

Question 6

What is the mnemonic for the secretory products of the adrenal cortex?

Answer 6

GFR corresponds with Salt (Na), Sugar (Glucocorticoid), and Sex (androgens). “The deeper you go, the sweeter it gets”.

Question 7

Which is the principal cell of the Medullary?

Answer 7

Chromaffin cells, also produces catecholamines (norepinephrine and epinephrine).

Question 8

What is the most common adrenal medulla tumor in adults?

Answer 8

Pheochromocytoma. Increase secretion of catecholamines that results in episodic hypertension.

Question 9

What is the most common adrenal medulla tumor in children?

Answer 9

Adrenal Neuroblastoma. Rarely causes hypertension.

Question 10

Why is important the fetal adrenal gland ?

Answer 10

Because the pneumocytes 2 cannot mature an start to secreting surfactor without Cortisol.

Question 11

Which enzyme convert cholesterol to pregnenolone?

Answer 11

Cholesterol Desmolase.

Question 12

Which drug inhibit cholesterol Desmolase?

Answer 12

Antifungal drug Ketoconazol for this reason inhibit all the production of all the steroids cortisol and testosterone. And also ACTH stimulates Desmolase.

Question 13

Which are the reactions where the enzyme 3-beta Hydroxysteroid dehydrogenase do?

Answer 13

Convert:

1) Pregnenolone to progesterone.
2) 17 alpha OH-Pregnenolone to 17 alpha OH-progesterone.
3) Dehydroepiandrosterone (DHEA) to Androstenedione.

Question 14

Which enzyme converts pregnenolone to 17 alpha OH-Pregnenolone and also progesterone to 17 alpha OH-Progesterone?

Answer 14

17alpha-Hydroxylase

Question 15

Which enzyme converts progesterone to Deoxycorticosterone and also converts 17alpha OH-progesterone to 11-Deoxycortisol?

Answer 15

21 alpha Hydroxylase

Question 16

Which enzyme converts:

1) Deoxycorticosterone to Corticosterone
2) 11-Deoxycortisol to Cortisol.

Answer 16

11beta-Hydroxylase.

Question 17

Which enzyme converts corticosterone to Aldosterone?

Answer 17

Aldosterone Synthetase.

Question 18

Angiotensin II

Answer 18

Aldosterone can be stimulates by angiotensin II.

Question 19

Which are the 2 actions of angiotensin II?

Answer 19

1) Potent vasoconstrictor.

2) Stimulates Aldosterone secretion.

Question 20

Which are the two products that androstenedione can be?

Answer 20

Estrone and testosterone

Question 21

Which enzyme convert Testosterone to Dihydrotestosterone (DHT)?

Answer 21

5alpha- reductase.

Question 22

Which drug inhibits 5alpha reductase?

Answer 22

Finasteride inhibit formation the more potent DHT

Question 23

Converts :

1) Androstenedione to Estrone –> Estriol.
2) Testosterone to Estradiol

Answer 23

Aromatase can find in the ovaries

Question 24

What happens if your patient have a 21alpha Hydroxylase deficiency?

Answer 24

There are not aldosterone and cortisol but there are more androgens and that produces masculinization, blood pressure low, hypekalemia,

Question 25

Which is the differences between 21alpha and 11beta deficiencies?

Answer 25

21 hypotension and 11 hypertension (mineralocorticoid)

Question 26

What happens with 17alpha Hydroxylase deficiency?

Answer 26

Only can produces mineralocorticoids that’s cause water retention and hypertension as well hypokalemia, ambiguous genitalia because de sex hormones are low.

Question 27

Which enzyme deficiency is inability to produces: high ACTH and low Cortisol.

• Glucocorticoids.
• Mineralocorticoids.
• Androgens.
• Estrogens.

Answer 27

3beta-Hydroxysteroid Dehydrogenase, also produces ambiguous genitalia, early death, and excessive sodium urine excretion.

Question 28

17alpha-Hydroxylase deficiency:

Answer 28

Inability to produce sex hormones and cortisol that’s causes phenotypic female unable to mature, also increased production of mineralocorticoids that causes sodium and fluid retention its produces hypertension.

Question 29

21-Hydroxylase Deficiency:

Answer 29

Inability to produces cortisol(high ACTH).
Inability to produces mineralocorticoids (Hypotension).
Increased production of sex hormones (Masculinization).

Question 30

11beta-Hydroxylase Deficiency:

Answer 30

Inability to produces: Cortisol, Corticosterone, Aldosterone.
Increased production of Deoxycorticosterone: Hypertension.
Increased production of sex hormones:Masculinization.

Question 31

What are the symptoms of 21alpha-Hydroxylase deficiency?

Answer 31

Hypotension and masculinization.

Question 32

What are the symptoms of 11beta-Hydroxylase deficiency?

Answer 32

Hypertension and masculinization.

Question 33

What food substance is an essential starting point in the synthesis of adrenal steroid?

Answer 33

Cholesterol

Question 34

From which structure is derived the cortex?

Answer 34

Cortex derived from Mesoderm.