A 60-year-old woman is being assessed for chronic fatigue and weakness. She has no other medical issues and does not take any medications. Following preliminary laboratory studies, the physician decides to perform a metyrapone stimulation test. The graph below depicts the changes in urinary 17-hydroxycorticosteroid (17-OHS) excretion after metyrapone administration. Which of the following mechanisms is most likely responsible for the findings seen in the graph?

Question

A 60-year-old woman is being assessed for chronic fatigue and weakness. She has no other medical issues and does not take any medications. Following preliminary laboratory studies, the physician decides to perform a metyrapone stimulation test. The graph below depicts the changes in urinary 17-hydroxycorticosteroid (17-OHS) excretion after metyrapone administration.  Which of the following mechanisms is most likely responsible for the findings seen in the graph?

Quizplus · Accepted Answer

Eductional Objective: Metyrapone inhibits 11-Beta-hydroxylase, which results in a decrease in cortisol synthesis. This will result in a reactive increase in ACTH, 11-deoxycortisol, and urinary 17-hydroxycorticosteroid levels in patients with an intact hypothalamic-pituitary-adrenal axis.

A 60-Year-Old Woman Is Being Assessed for Chronic Fatigue and Weakness