que--endocrine - targt250

[ArchivalUser]

The correct answer is B. In individuals with
17α-hydroxylase defi ciency, ACTH secretion is elevated secondary to decreased cortisol levels.
The goal of treatment with hydrocortisone is
not only to replenish cortisol, but also to suppress
ACTH secretion. The reason for this is
that if ACTH remains high, it will stimulate
androgen production and lead to premature virilization
and growth plate ossifi cation. Nightly
dexamethasone treatments may be necessary to
more completely suppress ACTH secretion in
adolescents.
Answer A is incorrect. Cosyntropin stimulates
ACTH production, and cosyntropin levels are
used to diagnose 21-hydroxylase defi ciency.
Answer C is incorrect. Spironolactone is a potassium-
sparing diuretic and would not affect
ACTH levels.
Answer D is incorrect. Increased hydrocortisone
alone may not be suffi cient to suppress
ACTH secretion in this patient.
Answer E is incorrect. This individual is exhibiting
signs of increased virilization and likely
needs further suppression of ACTH secretion
to prevent premature skeletal maturation

[ArchivalUser]

i guess here the defeciency is only partial,

[ArchivalUser]

ACTH stimulates uptake of cholesterol and synthesis of pregnenolone.

pregnenolone is an endogenous steroid hormone involved in the steroidogenesis of progestogens, mineralocorticoids, glucocorticoids,*** androgens**, and estrogens, as well as the neuroactive steroids.

Wikipedia

Thank you

[ArchivalUser]

thank you my250 and target250. And like you said, may be the deficiency is only partial. Cause if it was full deficiency, the feature would be enuchoid as a whole and although dexa is given to supress ACTH, the virilization effect would not happen at all.

thank you for the Q