Saturday, December 14, 2013

Adrenal Steroids

  • Enzymes order like a floors order in a building: 11b, 21, 17a
    • Deficiency increase the upper floor enzyme:
      •  11b deficiency increases 21, and 17a
      •  21 deficiency increases 17a
  • ALL deficiencies have:
    • Increased ACTH
    • Decreased Cortisol
  • When Aldosterone is increased -> Na increased vs K decreased (opposite)
  • If Na increases = Blood  pressure increases = fluid retention
  • K is H brother and pH enemy -> K increases = pH decreases


  1. Q: A 46,XX newborn is born at 38 weeks' gestation with ambiguous genitalia. Laboratory studies show a blood glucose of 65 mg/dL, potassium of 5.5 mEq/L, and salt wasting. Serum 17-OH progesterone is markedly increased. Which adrenal enzyme deficiency is the most likely diagnosis?

    A: 21-hydroxylase deficiency

  2. Glucocorticoids are distinguished from mineralocorticoids and sex steroids by their ..... Glucocorticoids may be used in low doses in adrenal insufficiency. testoterone