Podcast
Questions and Answers
Which one of the following is a characteristic of Conn's syndrome?
Which one of the following is a characteristic of Conn's syndrome?
- Deficiency of cortisol
- Deficiency of aldosterone
- Excess secretion of cortisol
- Excess secretion of aldosterone (correct)
What is the effect of Conn's syndrome on water and electrolyte balance?
What is the effect of Conn's syndrome on water and electrolyte balance?
- Decreased water retention and decreased potassium excretion
- Increased water retention and decreased potassium excretion (correct)
- Decreased water retention and increased potassium excretion
- Increased water retention and increased potassium excretion
How can a diagnosis of primary hyperaldosteronism be confirmed?
How can a diagnosis of primary hyperaldosteronism be confirmed?
- Measurement of plasma aldosterone levels
- Measurement of plasma sodium levels
- Measurement of plasma renin levels (correct)
- Measurement of plasma cortisol levels
Which enzyme is deficient in the case of 11 beta hydroxylase deficiency?
Which enzyme is deficient in the case of 11 beta hydroxylase deficiency?
What is the expected level of serum 17-(OH)-progesterone in the case of 11 beta hydroxylase deficiency?
What is the expected level of serum 17-(OH)-progesterone in the case of 11 beta hydroxylase deficiency?
What is the expected level of 24 h urine pregnanetriol in the case of 11 beta hydroxylase deficiency?
What is the expected level of 24 h urine pregnanetriol in the case of 11 beta hydroxylase deficiency?
Will renin be elevated in the case of 11 beta hydroxylase deficiency?
Will renin be elevated in the case of 11 beta hydroxylase deficiency?
Which of the following is a direct effect of aldosterone?
Which of the following is a direct effect of aldosterone?
Which of the following is a primary cause of hyperaldosteronism?
Which of the following is a primary cause of hyperaldosteronism?
What is the primary stimulus for aldosterone secretion?
What is the primary stimulus for aldosterone secretion?
How can primary hyperaldosteronism be diagnosed?
How can primary hyperaldosteronism be diagnosed?
Which of the following is the primary stimulus for aldosterone secretion in the renin-angiotensin system?
Which of the following is the primary stimulus for aldosterone secretion in the renin-angiotensin system?
Which of the following is a consequence of excess aldosterone secretion?
Which of the following is a consequence of excess aldosterone secretion?
Which of the following factors independently stimulates aldosterone secretion?
Which of the following factors independently stimulates aldosterone secretion?
What is the main role of aldosterone in the body?
What is the main role of aldosterone in the body?
Which enzyme deficiency is the most common cause of Congenital Adrenal Hyperplasia (CAH)?
Which enzyme deficiency is the most common cause of Congenital Adrenal Hyperplasia (CAH)?
Which hormone is primarily affected in CAH?
Which hormone is primarily affected in CAH?
What is the main effect of severe 21 hydroxylase deficiency on aldosterone synthesis?
What is the main effect of severe 21 hydroxylase deficiency on aldosterone synthesis?
What is the main effect of severe 21 hydroxylase deficiency on androgen synthesis?
What is the main effect of severe 21 hydroxylase deficiency on androgen synthesis?
Which of the following is a characteristic of adrenal adenomas and carcinomas compared to FHA and unilateral hyperplasia?
Which of the following is a characteristic of adrenal adenomas and carcinomas compared to FHA and unilateral hyperplasia?
Which gene is involved in the unequal crossing over between 11b hydroxylase (CYP11B1) and aldosterone synthase (CYP11B2) genes in Familial Hyperaldosteronism type I (FHI)?
Which gene is involved in the unequal crossing over between 11b hydroxylase (CYP11B1) and aldosterone synthase (CYP11B2) genes in Familial Hyperaldosteronism type I (FHI)?
Which of the following drugs inhibits 11 beta hydroxysteroid dehydrogenase and can lead to increased aldosterone levels?
Which of the following drugs inhibits 11 beta hydroxysteroid dehydrogenase and can lead to increased aldosterone levels?
Which of the following is a common finding in primary hyperaldosteronism?
Which of the following is a common finding in primary hyperaldosteronism?
What is the expected urine potassium level in a patient with an adrenal tumor causing primary hyperaldosteronism?
What is the expected urine potassium level in a patient with an adrenal tumor causing primary hyperaldosteronism?
What is the cause of Liddle's syndrome?
What is the cause of Liddle's syndrome?
What is the primary cause of hyperaldosteronism in Bartter's syndrome?
What is the primary cause of hyperaldosteronism in Bartter's syndrome?
Study Notes
Characteristics of Conn's Syndrome
- Hypertension and hypokalemia are characteristic of Conn's syndrome
- Conn's syndrome is a consequence of excess aldosterone secretion
Effect on Water and Electrolyte Balance
- Excess aldosterone secretion leads to water retention and potassium depletion
- This can result in hypokalemia and hypertension
Diagnosis of Primary Hyperaldosteronism
- Primary hyperaldosteronism can be diagnosed with adrenal vein sampling
- This is used to lateralize aldosterone secretion to one adrenal gland
11 Beta Hydroxylase Deficiency
- 11 beta hydroxylase deficiency is an autosomal recessive disorder
- 11 beta hydroxylase is an enzyme involved in cortisol synthesis
- Deficiency of this enzyme leads to increased levels of 17-alpha-hydroxyprogesterone
- This results in virilization and hypertension
Serum and Urine Levels in 11 Beta Hydroxylase Deficiency
- Serum 17-alpha-hydroxyprogesterone levels are elevated in 11 beta hydroxylase deficiency
- 24-hour urine pregnanetriol levels are also elevated in this condition
- Renin levels are decreased in 11 beta hydroxylase deficiency due to volume expansion
Effects of Aldosterone
- Aldosterone stimulates sodium reabsorption and potassium excretion in the distal nephron
- This leads to hypertension and hypokalemia
Causes of Hyperaldosteronism
- Primary hyperaldosteronism is caused by adrenal adenoma or carcinoma
- Secondary hyperaldosteronism is caused by renovascular disease or reninoma
Regulation of Aldosterone Secretion
- Aldosterone secretion is stimulated by angiotensin II, potassium, and ACTH
- The renin-angiotensin-aldosterone system is the primary regulator of aldosterone secretion
Diagnosis of Congenital Adrenal Hyperplasia (CAH)
- CAH is caused by 21 hydroxylase deficiency in 90% of cases
- CAH leads to virilization and ambiguous genitalia in females
Effects of 21 Hydroxylase Deficiency
- 21 hydroxylase deficiency leads to decreased aldosterone synthesis
- This results in salt wasting and hypotension
- 21 hydroxylase deficiency also leads to increased androgen synthesis
- This results in virilization and ambiguous genitalia in females
Adrenal Tumors
- Adrenal adenomas and carcinomas are frequently unilateral
- They are characterized by unilateral adrenal hyperplasia
Familial Hyperaldosteronism Type I (FHI)
- FHI is caused by unequal crossing over between CYP11B1 and CYP11B2 genes
- This results in the ectopic expression of aldosterone synthase in the adrenal zona fasciculata
Inhibitors of 11 Beta-Hydroxysteroid Dehydrogenase
- Glycyrrhetinic acid inhibits 11 beta-hydroxysteroid dehydrogenase
- This leads to increased aldosterone levels and hypertension
Primary Hyperaldosteronism
- Primary hyperaldosteronism is characterized by hypertension and hypokalemia
- Urine potassium levels are decreased in primary hyperaldosteronism
Liddle's Syndrome
- Liddle's syndrome is caused by activating mutations of the beta subunit of the epithelial sodium channel
- This results in excessive sodium reabsorption and hypertension
Bartter's Syndrome
- Bartter's syndrome is caused by mutations of the thick ascending limb of the loop of Henle
- This results in excessive potassium wasting and hypokalemia
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Description
Test your knowledge on aldosterone deficiency, deoxycorticosterone, virilization, hypertension, and urinary 17-hydroxycorticosteroids. Explore the differences from 11 b hydroxysteroid dehydrogenase and learn about pregnenolone, progesterone, 11-deoxycorticosterone, corticosterone, and aldosterone. Take the quiz now!
