Treating excessive steroids with steroids! - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 03-08-2012
USMLE Forums Addict
 
Steps History: Not yet
Posts: 183
Threads: 79
Thanked 17 Times in 13 Posts
Reputation: 27
Question Treating excessive steroids with steroids!

12 year old boy has Autosomal Dominant disease with Ectopic overexpression aldosterone synthase
lab: increased 18-oxocortisol, increased 18 hydroxycortisol
whats the treatment?
a. candesartan
b. Dexamethasone
c. mannitol

ans: B
what is this disease and why do you give steroid if there is already high steroid?
Reply With Quote Quick reply to this message



  #2  
Old 03-08-2012
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 270
Threads: 34
Thanked 223 Times in 119 Posts
Reputation: 233
Default

This question has nothing to do with clinically relevant disease, they are testing whether you know about aldosterone production.

If you look at the aldosterone prod. pathway....the last step is conversion of corticosterone to aldosterone by aldosterone pathway. So basically what you have to do is decrease corticosterone production. The way to do this is to decrease ACTH as this is the signal to produce corticosterone.

Giving dexamethasone will suppress ACTH which will cause decreased corticosterone production. So even though aldosterone synthase levels can stay high it won't matter cuz there will be nothing to convert.
Reply With Quote Quick reply to this message
The above post was thanked by:
Mondoshawan (03-09-2012)
  #3  
Old 03-09-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,406
Threads: 118
Thanked 644 Times in 408 Posts
Reputation: 654
Default

Quote:
Originally Posted by haga View Post
This question has nothing to do with clinically relevant disease, they are testing whether you know about aldosterone production.

If you look at the aldosterone prod. pathway....the last step is conversion of corticosterone to aldosterone by aldosterone pathway. So basically what you have to do is decrease corticosterone production. The way to do this is to decrease ACTH as this is the signal to produce corticosterone.

Giving dexamethasone will suppress ACTH which will cause decreased corticosterone production. So even though aldosterone synthase levels can stay high it won't matter cuz there will be nothing to convert.
isn;t it true though that high dose dexamethasone does NOT decrease ectopic secretion of ACTH? in fact, thats the test by which we determine ectopic release vs release from pituitary in hypercortisolism, no?
__________________
"inflammable means flammable!? What a country."
Reply With Quote Quick reply to this message
The above post was thanked by:
DocSikorski (03-09-2012)
 
  #4  
Old 03-09-2012
USMLE Forums Addict
 
Steps History: Not yet
Posts: 183
Threads: 79
Thanked 17 Times in 13 Posts
Reputation: 27
Default

Quote:
Originally Posted by Dr.NickRiviera View Post
isn;t it true though that high dose dexamethasone does NOT decrease ectopic secretion of ACTH? in fact, thats the test by which we determine ectopic release vs release from pituitary in hypercortisolism, no?
its not ectopic ACTH secretion
it was ectopic aldosterone synthase overexpression
Reply With Quote Quick reply to this message
  #5  
Old 03-09-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 1,406
Threads: 118
Thanked 644 Times in 408 Posts
Reputation: 654
Default

Quote:
Originally Posted by kenlee View Post
its not ectopic ACTH secretion
it was ectopic aldosterone synthase overexpression
what reaction exactly does aldosterone synthase catalyze?
__________________
"inflammable means flammable!? What a country."
Reply With Quote Quick reply to this message



Reply

Tags
Biochemistry-, Physiology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Adrenal sex steroids & sexual characteristics rose USMLE Step 1 Forum 4 05-04-2016 11:57 PM
Steroids and increased BUN/creatine ratio chienpolska USMLE Step 2 CK Forum 3 12-27-2012 09:37 AM
Steroids: cytoplasmic vs nuclear receptors autumn USMLE Step 1 Forum 4 09-02-2011 05:51 PM
Ambiguous genitalia and low steroids khushboo USMLE Step 1 Forum 18 08-23-2011 05:10 PM
Excessive tearing baby! aghammoud85 USMLE Step 2 CK Forum 2 06-16-2011 09:41 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)