Chem chap 21

A genetic disorder causing a deficiency of certain enzymes in the synthetic pathways leading to cortisol and aldosterone production is referred to as:

Congenital adrenal hyperplasia

Hyponatremia (low serum sodium level) may be found in all of the following conditions EXCEPT: Addison's disease Diarrhea Renal tubular disease Conn's syndrome Congestive heart failure

Conn's syndrome

As a screening test for Cushing's syndrome, the physician wishes to see whether a patient exhibits normal diurnal rhythm of his cortisol secretion. At what time should the specimens be drawn for plasma cortisol determination? (Assume a daytime work schedule for the patient.)

8 AM, 8 PM

The definitive diagnosis of primary adrenal insufficiency requires demonstration of:

Impaired response to ACTH stimulation

A low-salt diet, low blood pressure, and diuretics would cause the following results:

Increased renin, increased aldosterone, hypernatremia, hypokalemia

A patient presents with Addison's disease. Serum sodium and potassium analyses are done. The results would reveal:

Low sodium, high potassium levels

In a patient who is suspected of having pheochromocytoma, measurement of which of the following urinary compounds would be the most useful?

Metanephrines

A patient is suspected of having Addison's disease. His laboratory tests show low serum sodium and chloride, elevated serum potassium, and elevated urine sodium and chloride levels. The aldosterone cortisol levels are decreased. To make a definitive diagnosis, the physician orders an ACTH stimulation test, and the cortisol level is measured again. If the patient has Addison's disease, the cortisol level would ________. If the patient has hypopituitarism, the levels would _______.

Remain the same; increase

The test for adrenal cortical hyperfunction that has the greatest diagnostic sensitivity is measurement of:

Urinary free cortisol

The FINAL metabolite of epinephrine that is measured in urine is:

Vanillylmandelic acid