physiology question

[dr g]

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which of the following would be expected in a woman with isolated ACTH deficiency?
1 decreased pubic and axillary hair
2 decreased serum sodium concentration
3 hyperpigmentation
4 increased serum cortisol
5 increased serum pottasium

i think it should be hyperpigmentation
but acc to kaplan it is decresed pubic and axillary hair and hyperpigmentation is in incresed ACTH production

but hyperpigmentation is in addison's disease which is due to decreased cortisol and decreased ACTH

please help

 

[dent_coorg]

Hi,

According to me it is decreased sodium resorption 4m kidney coz, ACTH acts on adrenal cortex and release ALDOSTERON, which causes Na resorption 4m kidney.
So decreased ACTH, decreases ALDOSTERON which inturn decreases Na reabsorption.

correct me if im wrong.

 

[dent_coorg]

therefore decreased serum Na concentration.

 

[drmon]

which of the following would be expected in a woman with isolated ACTH deficiency?
1 decreased pubic and axillary hair
2 decreased serum sodium concentration
3 hyperpigmentation
4 increased serum cortisol
5 increased serum pottasium

i think it should be hyperpigmentation
but acc to kaplan it is decresed pubic and axillary hair and hyperpigmentation is in incresed ACTH production

but hyperpigmentation is in addison's disease which is due to decreased cortisol and decreased ACTH

please help

i think the q is about secondary adrenal insufficiency (isolated ACTH deficiency) which u are confusing with primary adrenal insufficiency(addison's disease).

Addison's disease refers specifically to primary adrenal insufficiency, in which the adrenal glands themselves malfunction; secondary adrenal insufficiency occurs when the anterior pituitary gland does not produce enough adrenocorticotropic hormone (ACTH) to adequately stimulate the adrenal glands.
therefore in secondary adrenal insufficiency,the hormones (maily produced by zona f and zona r ); glucocoricoids,androgens are deficient.this decrease in androgens is responsible for decreased pubic and axillary hair.

since ACTH is insufficient,there is no reason for hyperpigmentation.

hope this helps 👍

 

[mam6701e]

Hi,

According to me it is decreased sodium resorption 4m kidney coz, ACTH acts on adrenal cortex and release ALDOSTERON, which causes Na resorption 4m kidney.
So decreased ACTH, decreases ALDOSTERON which inturn decreases Na reabsorption.

correct me if im wrong.

Agree w/you. Very clearlly ecplained.
Secundary hypoaldosteronism decreases aldosterone , therefore less Na reabsorbed by kidneys and more K reabsoreved. Decrease Na, water and hypotension

 

[dental doc80]

which of the following would be expected in a woman with isolated ACTH deficiency?
1 decreased pubic and axillary hair
2 decreased serum sodium concentration
3 hyperpigmentation
4 increased serum cortisol
5 increased serum pottasium

i think it should be hyperpigmentation
but acc to kaplan it is decresed pubic and axillary hair and hyperpigmentation is in incresed ACTH production

but hyperpigmentation is in addison's disease which is due to decreased cortisol and decreased ACTH

please help

i think the ans should be hyperpigmentation........

and jus to add 1 moe thing.......ACTH doesnot causes the release of aldosterone harmone from adrenal cortex......aldosterone release is influenced by the potassium levels in the body.....therefore options 2 and 5 are completely wrong...

 

[mam6701e]

which of the following would be expected in a woman with isolated ACTH deficiency?
1 decreased pubic and axillary hair
2 decreased serum sodium concentration
3 hyperpigmentation
4 increased serum cortisol
5 increased serum pottasium
i think it should be hyperpigmentation
but acc to kaplan it is decresed pubic and axillary hair and hyperpigmentation is in incresed ACTH production

but hyperpigmentation is in addison's disease which is due to decreased cortisol and decreased ACTH

please help

here is why:
This question is refer to secondary hypoaldosteronism coz an organ or in this case a hormone other thatn the organ (adrenal gland) is affected.
primary(Addisson disease) and secunday hypoaldosteronism deffer in primary affects directly the adrenal and sexcundary affects the ACTH.
The other diference is that primary affects both gluco and mineralocorticoids. Secundary affects only mineralocorticoids(aldosterone)
1 decreased pubic and axillary hair, cannot be coz it would be the answer if the question was asking about primary Hypoaldosrteronism (Addison), coz adrenal androgens are affected, in this case adrenal glands are working well.
2 decreased serum sodium concentration cannot be coz it is releted to glucocorticoids. In adison disease glucocorticoids are not enough, so there is hypoglycemia and then hyponatremia
3 hyperpigmentation , these is less close to the answer, as #4, cannot be coz there is a decrease of ACTH not increase. When ACTH is increase it incresesb-lipotropin which releases b-mSH, the responsible of darkness of skin.
4 increased serum cortisol, this is less close to the answer coz cortisol increase when ACTH increase, and then cortisol is a negative feedback for ACTH

5 increased serum potassium is the answer indeed coz it is related to mineralocorticoids (aldosterone), which is decreased, remember in secondary only aldosterone is affected, no cortisol, so insufficient mineralocorticoids (aldosterone) impairs K and H increase, leading to hyperkalemia (increase K in the EC) and metabolic acidosis.

 

[keyvan]

The answer is 1-decreased pubic and axillary hair

We have decreased ACTH and decreased cortisol :

1-Female patients may show an absence of axillary and pubic hair and decreased body hair. This is due to loss of the adrenal androgens, a major source of androgens in women.

2- ACTH stimulation is not normally the major stimulus for aldosterone production; it increases aldosterone production to peak levels within 30 minutes. This response, however, is affected by dietary sodium intake.

3-It is caused by the stimulant effect of excess adrenocorticotrophic hormone (ACTH) on the melanocytes to produce melanin.

4- Obviously Wrong!

5- Refer to 2

 

[dr g]

thanx guys
the input was really helpful