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 11 b OH deficiency.  



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Author9 Posts
  #1

I am confused, in kaplan book, it says, due to this deficiency 11 deoxycorticosterone will go up(above the block) rise in BP and this one is produced in zona glomerulosa. But in video lecture Dr Dunn says, only weak mineralocorticoids in zona fasciculata and reticularis will be increased(????), everything else of zona glomerulosa will shut down because, due to increased BP, there will be low renin, and low Angiotensin II, this lack of angiotensin II will shut down zona glomerulosa. If he is right which are weak mineralocorticoids in zona fasciculata and reticularis. i am confused now.

can anyone clarify this?





  #2

https://www.prep4usmle.com/forum/thread/54714/

there was a huge discussion on this a while back.

check it out....hopefully you'll get it

it is a very important concept and a bit tricky!



  #3

Aldosterone,which is the major mineralocorticoid,is the only hormonal output of the zona glomerulosa.11-deoxycorticosterone(a weak mineralocorticoid),corticosterone(a weak glucocorticoid),cortisol(the major glucocorticoid),and androgens are the hormonal outputs of zona fasciculata and reticularis.

In 11-beta-OH-deficiency,cortisol and corticosterone output from zona fasciculata and reticularis will be decreased.So there is a complete glucocorticoid deficiency.ACTH levels are increased due to the decreased negative feedback inhibition effect of cortisol on ACTH..Aldosterone output from the zona glomerulosa will be decreased.11-deoxycorticosterone(a weak mineralocorticoid)output from zona fasciculata and reticularis is increased due to the excessive stimulating effect of ACTH on zona fasciculata and reticularis.Increased levels of 11-deoxycorticosterone will cause rise in BP which inhibits RAA axis.Also excessive androgens are released from zona fasciculata and reticularis.

Overall effect is--->atrophy of zona glomerulosa due to decreased levels of angiotensin 2 and hyperplasia of zona fasciculata and reticularis due to increased ACTH levels.

Hope im clear.





  #4

Anti Dep the particular point that you have asked about Dunn has been discussed in the link provided by Silver. look at post #26.



  #5

thanks pr20, silver and NNL.

thanks for referring me to that discussion, i was scratching my head and not finding any diagram/flowchart/ifgure in kaplan that showed 11 Deoxycorticosterone is produced from zona fasciculata, and zona reticularis, but Dr Dunn is saying that.(agree totally with silver in that regard). I dont have any other book that showed 11 DOC is in zona fasciculata, and reticularis. Thanks God you guys found it somewhere, otherwise it would remain a confusion forever. we only believe if its written.sticking out tongue



  #6

Kaplan physiology clearly states the hormonal outputs of different parts of adrenal gland under the heading "regional synthesis".



  #7

thank pr20, didnt read that part, only read from the figure IX-3-3 first time and listened lecture focusing on that figure( i didnt think that they have anything extra in description), that time it didnt hit me the difference, now listening 2nd time, i realized i didnt even pay attention about zona fasciculata and reticularis has this, i guess it was not easy for them to include this in figure.

anyway, long story short, confusion resolved.nod



  #8

Here are the diagrams which are being referred to in the text.



Attached Files:
11 DOC prodcution in Fasciculata and Reticularis.doc (443 KB, 5 downloads)

  #9

It happens to everyone of us...sometimes we don't give attention to some points until we see a question on that.Thats why they say that every point in kaplan books is important for the exam.






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