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Endo/Repro Exam 2 > Adrenal Androgens > Flashcards

Adrenal Androgens Flashcards

1
Q

Where are adrenal androgens produced?

A

Zona reticularis of the adrenal cortex

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2
Q

What three adrenal androgens are released from the zona reticularis?

A

Dehydroepiandrosterone (DHEA)
Androstenedione
Testosterone

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3
Q

What receptor takes in cholesterol for steroid hormone production?

A

SRB1 (scavenger receptor class B member 1)

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4
Q

What binds to SRB1?

A

LDL

HDL

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5
Q

What regulates the synthesis of adrenal androgens?

A

ACTH

CASH (cortical androgen stimulating hormone)

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6
Q

What binds and carries androgens in the blood?

A

SHBG (sex hormone binding globulin)

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7
Q

What has a negative feedback on ACTH?

A

Only cortisol not any other steroid hormone

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8
Q

What receptor does ACTH bind to in the adrenal cortex?

A

MC2R (melanocortin-2 receptor)

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9
Q

What does cortisol inhibit?

A

CRH from hypothalamus

ACTH and CASH from anterior pituitary

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10
Q

What are two different forms of DHEA?

A

DHEA

DHEAS (sulfate)

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11
Q

Which DHEA has a longer half-life?

A

DHEAS

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12
Q

Where is testosterone mostly created?

A

Leydig cells in the testes (95%)

Only 5% created in the zona reticularis

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13
Q

How is testosterone carried in the blood?

A

98% binds to albumin and SHBG

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14
Q

What are the most abundant steroid hormones in the bloodstream?

A

DHEA

DHEAS

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15
Q

What is adrenarche?

A

Period in time (10-11 years of age) in which the zona reticularis is developed and begins to create androgens in an increased level without increased cortisol

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16
Q

When does adrenarche occur?

A

Age of puberty 10-11 years old

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17
Q

Where does DHEA go in premenopausal females?

A

Ovary for estradiol (E2) and testosterone formation

Mammary gland

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18
Q

Where does DHEA go in males?

A

Testes for testosterone production

Prostate

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19
Q

What does 11B-HSD2 do?

A

Converts cortisol to cortisone

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20
Q

Free androgens (DHT/Estradiol) are highly metabolized where in the body?

A

Liver and excreted by the kidney

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21
Q

What are the metabolites of DHT and Estradiol?

A

Androsterone

Etiocholanolone

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22
Q

Effects of DHEA?

A

Pubertal growth spurt (essentially everything involved in growing)

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23
Q

Effect of estrogen on bones?

A

Epiphysis fusion of bones and mineralization

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24
Q

Effect of DHEA on immune system?

A

Antagonizes cortisol

25
Q

What is the effect of DHEA on endothelial function?

A

Increases eNOS -> NO production causing vasodilation

26
Q

What does 5alpha-reductase do?

A

Converts testosterone to DHT

27
Q

What does aromatase do?

A

Converts testosterone to estradiol

28
Q

What does a deficiency in aromatase or estrogen receptor cause?

A

Failure to fuse long bones

Osteoporosis

29
Q

What develops from the Wolffian mesonephric duct?

A

Epididymis
Vas deferens
Seminal vesicle
Ejaculatory duct

30
Q

What develops from the Mullerian paramesonephric duct?

A

Fallopian tubes
Uterus
Upper part of vagina

31
Q

What genes on the Y chromosome determines the sex of the fetus?

A

SRY gene

32
Q

SRY gene in gonads causes formation of Sertoli cells, what do the Sertoli cells release?

A

Mullerian inhibiting substance (MIS)

33
Q

What does MIS cause?

A

Mullerian duct degeneration

34
Q

SRY gene in gonads causes formation of Leydig cells, what do the Leydig cells release and the effect?

A

Testosterone

Causes Wolffian duct development

35
Q

What medical problem in women has the highest negative impact on morbidity?

A

Menopause

36
Q

What occurs to sodium and potassium levels in 21-alpha hydroxylase deficiency?

A

Hyponatremia

Hyperkalemia

37
Q

Why do you have Hyponatremia and hyperkalemia in 21-alpha hydroxylase deficiency?

A

Decreased aldosterone not

38
Q

What does a 21-alpha hydroxylase deficiency cause in steroid hormone production?

A

Cannot produce mineralocorticoids or glucocorticoids so it is shunted to formation of androgens

39
Q

Most common congenital genetic enzymatic defect in steroid hormone synthesis?

A

21-hydroxylase (same as 21-alpha hydroxylase)

40
Q

Second most common congenital genetic enzymatic defect in steroid hormone synthesis?

A

11-beta hydroxylase

41
Q

What occurs in 21 alpha-hydroxylase deficiency?

A

ACTH loss of negative feedback
Increased androgen shunting
Virilization

42
Q

What is Virilization?

A

Presence of masculine traits

43
Q

What occurs in 11 beta-hydroxylase defects?

A

Increase in deoxycortisol/deoxycorticocosterone
Decrease but not loss of cortisol negative feedback
Increased androgen shunting/Virilization
Salt and water retention (hypertension)

44
Q

Why do you still have mild ACTH negative feedback and hypertension in 11 beta-hydroxylase defects but not 21 alpha-hydroxylase defects?

A

Because in 11 beta-hydroxylase you have a build up of the intermediates (deoxycortisol/deoxycorticocosterone) that have mild effects on ACTH and large effects on ENaC (increased Na retention)

45
Q

Effects of 17 alpha-hydroxylase deficiency?

A

Increase in mineralocorticoids and aldosterone

46
Q

What is androgen insensitivity syndrome?

A

Mutation in androgen receptor such that tissues do not respond to testosterone or other androgens

47
Q

What gonads develop in androgen insensitivity syndrome?

A

The testes

48
Q

What do individuals develop as externally with androgen insensitivity syndrome?

A

Female (they are XY males though)

49
Q

How is androgen insensitivity syndrome detected?

A

Amenorrhea (lack of menstruation)

50
Q

Proper development of what is dependent on DHT?

A

Penis

Prostate gland

51
Q

What occurs in 5-alpha reductase type 2 disorder?

A

Males are born with female-appearing external genitalia

Hypospadias (penis doesn’t enlarge)

52
Q

What occurs at puberty in 5 alpha-reductase disorder?

A

Large levels of circulating testosterone stimulate development of male structures

53
Q

What does the drug Abiraterone do?

A

Inhibits both 17,20-lyase and 17 alpha-hydroxylase

54
Q

What does Abiraterone administration result in?

A

Inhibition of androgen and glucocorticoid synthesis and shunting to mineralocorticoid synthesis

55
Q

What gene does CYP17A1 code for?

A

17,20-lyase and 17 alpha-hydroxylase

56
Q

When is Abiraterone administered?

A

Prostate hyperplasia

Prostate cancer

57
Q

What is given with Abiraterone to counteract the effects of decreased glucocorticoids?

A

Prednisone

58
Q

What is Kennedy’s disease?

A

X-linked bulbospinal neuropathy

59
Q

What occurs in Kennedy’s disease?

A

Androgen receptor mutation

Endo/Repro Exam 2 (18 decks)

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