11 results
Steroid Synthesis Pathway

(OH, hydroxy; HSD, hydroxysteroid dehydrogenase; DHEA, dehydroepiandrosterone; pink, common enzymes affecting CAH, purple –
dehydrogenase; DHEA
A diagnostic approach to secondary amenorrhea. (DHEA-S = dehydroepiandrosterone sulfate; FSH = follicle-stimulating hormone; LH =
(DHEA-S = dehydroepiandrosterone
Benign Adrenal Mass - Differential Diagnosis Algorithm
Hyperplasia - Often Bilateral
 • Congenital Adrenal Hyperplasia
 • ACTH
Hirsutism • High DHEAS ... • Low DHEAS ... Mass • Normal DHEAS
Hirsutism & Virilization - Differential Diagnosis Algorithm
ADRENAL EXCESS
Ovarian
 • Polycystic Ovarian Syndrome
 • Hyperthecosis
 • Tumor
Adrenal
• Testosterone DHEA
Malignant Adrenal Mass - Differential Diagnosis Algorithm
Suggestive of Malignancy: Inhomogenous Density, Delay in CT Contrast Washout
Hirsutism • High DHEAS ... Carcinoma) • Normal DHEAS
Hirsutism - Differential Diagnosis Algorithm
RAPID ONSET
Medications
 • Steroids
 • Danazol
 • Progestin Containing Contraceptives
Increased Serum Testosterone
Increased Serum DHEAS
Primary Adrenal Insufficiency
Addison's Disease - Damage of the adrenal glands with lack of cortisol, androgens and
present) ↓ DHEA ... Labs: ↓ Serum DHEAS
ACTH
LH
Cholesterol
cholesterol desmolase
Pregnenolone
17a-hydroxylase 17 Hydroxyregnenolone
17,20-lyase
3B-hydroxysteroid
dehydrogenase
3B-hydroxysteroid
dehydrogenase
17a-hydroxylase
#Progesterone
17-Hydroxyprogesterone
17,20-lyase
21ß-hydroxylase
21ß-hydroxylase
11-Deoxycorticosterone
11-Deoxycortisol
11ß-hydroxylase
11ß-hydroxylase
#Cortisol
#Dehydroepiandrosterone
#DHEA
3ß-hydroxysteroid
dehydrogenase
个
#Androstenedione
#17B-hydroxysteroid
#dehydrogenase
#Testosterone
#aromatase
#FSH
#Estradiol
#5a reductase
#Corticosterone
aldosterone synthase
#Aldosterone
Angiotensin ||
#Dihydrotestosterone
(DHT)
Dehydroepiandrosterone #DHEA
Allopecia - Differential Diagnosis Framework for Hair Loss

Localized / Focal Hair Loss Pattern:
 • Scarring Alopecia:
Prolactin, FSH, LH, DHEAS
Prescription Fish Oils
Prescription fish oils, Lovaza, and Vascepa, are commonly used for treatment of hypertriglyceridemia (TG
LDL due to the DHA