Liquorice misuse, by inhibiting 11 beta-hydroxysteroid dehydrogenase type 2 enzyme, can cause a condition which resembles the clinical features of:
Mineralocorticoid excess
11-beta-hydroxysteroid dehydrogenase type 2 normally inactivates cortisol to cortisone in mineralocorticoid-responsive tissues. Liquorice (glycyrrhizic acid) inhibits this enzyme, allowing cortisol to act on mineralocorticoid receptors, causing apparent mineralocorticoid excess (hypertension, hypokalemia, metabolic alkalosis).
Important Questions from Adrenal Disorders
- Which one of the following is a cause of Secondary Hyperaldosteronism?
Which of the following are correct regarding Cortisol?
1. Levels are highest in the morning on waking.
2. Cortisol falls dramatically during an illness.
3. More than 95% circulating cortisol is protein bound.
4. It is the major glucocorticoid in humans and can also activate mineralocorticoid receptors.
Select the answer using the code given below :
- A 50-year lady, who is a known case of rheumatoid arthritis, presents with obesity, moon facies, abdominal striae and hypertension. Overnight dexamethasone suppression test shows serum cortisol is greater than 50 nmol/L, serum ACTH is less than 1.1 pmol/L. The adrenal imaging and brain CT/MRI imaging studies are unremarkable. The likely diagnosis is
- Hirsutism is seen in which of the following ?
1. Polycystic ovarian syndrome
2. Congenital adrenal hyperplasia
3. Hypothyroidism
4. Ovarian tumour
Select the correct answer using the code given below: - A patient presents with circulatory shock, nausea, vomiting and diarrhoea. A diagnosis of acute adrenal crisis is considered. A blood sample is stored for measurement of serum cortisol and treatment started without delay. Which of the following are appropriate interventions?
1. IV normal saline
2. IV hydrocortisone 100 mg stat
3. IV 10% glucose
4. IV KCl as infusion
Select the correct answer using the code given below:
