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Medical Physiology > Adrenal Cortex > Flashcards

Adrenal Cortex Flashcards

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USMLE® Step 1 flashcards
1
Q

Zona Glomerulosa

A

synthesis and releases aldosterone

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2
Q

Why cortisole converts to cortisone

A

to prevent inappropriate mineral corticoid activity, since cortisol and aldosterone have the same R.

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3
Q

Cortisol transport

A

bound to corticosteroid binding globulin- Transcortin

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4
Q

DHEAS

A

dehydropinandrosterone

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5
Q

ACTH ST effect on zona fasiculata

A

induced cortisol production: enhanced cholesterol translocation into mt

activating the StAR transporter and demolase

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6
Q

responsible for auxilary hair and libido in women. and in prepubescent boys induces pubic hair growth

A

androgens

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7
Q

glucocorticoids synthesized in

A

adrenal cortex> Zona fasciculate

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8
Q

Most of the cholesterol utilized is imported from

A

blood- Cholesterol is part of LDL

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9
Q

Conversion of cholesterol into pregnenolone takes place in —– and is catalyzed by ——–

A

Mitochondria, Desmolase (CYP11A1)

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10
Q

Impact of cortisol on CT and Blood

A

Connective tissue: inhibits fibroblast proliferation and collagen synthesis by fibroblasts.

Blood: stimulates erythropoietin synthesis

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11
Q

Increases the activity of CEH

A

PKA phosphorylated CEH and inc. its activity

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12
Q

Zona reticularis secrets these:

4- items

A

DHEA
DHEAS
Testosterone
androstenedione

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13
Q

CEH

A

Cholesteryl ester hydrolase

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14
Q

The two compartments of adrenal cortex 3 zones in which synthesis takes place

A

Mitochondria and SER

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15
Q

Metabolism effects of cortisol on lipogenesis and plasma glucose level

A

decrease lipogenesis and increase plasma glucose level

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16
Q

ACTH intermediate effect on zona fasiculata

A

gene up-regulation, additional cortisol production

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17
Q

sex hormones are senthesized and released by

A

Adrenal cortex> Zona Reticularis

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18
Q

The major regulator of Na+, K+ and plasma volume

A

Aldosterone

Zona glomerulosa of adrenal cortex

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19
Q

ATP—>cAMP catalyzed by

A

AC

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20
Q

Corticosterone is synthesized and secreted in

A

cortisol secreting cells

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21
Q

The rate determining step of adrenal hormone synthesis in all three layers:

A

Conversion of cholesterol to pregnenolone by desmolase

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22
Q

Aldosterone is synthesized in

A

Adrenal cortex > Zona Glomerulosa

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23
Q

Hypothalamus pituitart Adrenal Gland Axix

1- ACTH:R —> AC (activation via Gs)
2- ATP —> cAMP
3- cAMP activates protein kinase A and the kinase phosphorylates
4-

A

Cholesteryl ester hydrolase (CEH)

and increases its activity

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24
Q

CONNS disease is an example of

A

Hyperaldosteronism

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25
Q

Zona Reticularis

A

synthesizes and release sex hormones

26
Q

addisons disease is an example of

A

HYPOaldosteronism

27
Q

All adrenal steroid hormones are derived from

A

Cholesterol

28
Q

First step of adrenal hormone synthesis in all 3 cortical layers

A

3 pathways-

1st step- Cholesterol translocation into mitochondria and conversion into pregnenolone

29
Q

Deficiency of mineralocorticoids

A 
HYPOaldosteronism
Adrenal destruction
ADDISON’s DISEASE
Clinically:	
Hyponatremia
Hyperkalemia
Mild Acidemia
Hypotension
↓ECF Volume : SHOCK
DEATH (Days-Weeks)
Treatment:
Mineralocorticoids
NaCl
30
Q

impact of cortisol on bone

A

Bone:
Increases bone resorption.
Decreases plasma calcium level: Decrease intestinal calcium absorption, decrease renal calcium reabsorption.

31
Q

Metabolism effects of cortisol on appetite and lipolysis

A

increase appetite and lipolysis

32
Q

Upon binding of ACTH to its Receptor (R) ——- is activated via Gs.

A

AC- Adenyl Cyclase

33
Q

ACTH, cortisol, androgens and aldosterone all follow this pattern to some degree

A

Diurnal regulation

Pulsatile and diurnal patterns

34
Q

Normal response to stress (in contrast to Cushing’s syndrome)

A

inc. cortisol
dec. insulin/ glucagon ratio
inc. epi/norepi from sympathoadrenal output

35
Q

Hypoaldosteronism

A

deficiency of mineralocorticoid due to adrenal destruction

36
Q

HYPERaldosteronism

A

excessive mineralocorticoids,

Adenoma (glomerulosa)

37
Q

Formation of testosterone and dihydrotestostrone in the priphery

A

DHEAS can be converted to DHEA and it and androstenedione are converted to the active androgens, testosterone and dihydrotestosterone in the periphery (adipose tissue, liver, skin, urogenital system).

38
Q

In short term StAR transporter and demolase are activated via

A

ACTH

39
Q

ACTH LT effect on Zona Fasiculata

A

induced hyperplasia and organelle elaboration- mt

40
Q

Cortisol inactivation

A

Cortisol cross reacts with aldosterone receptor,
to prevent inappropriate mineral corticoid activity, aldosterone target cells reversibly inactivate it by converting it to cortisone.

41
Q

Zona Fasciculata

A

synthesizes and releases glucocorticoid

42
Q

Excess mineralocorticoids

A 
HYPERaldosteronism
Adenoma (Glomerulosa)
CONN’s DISEASE
Clinically:	
Hypernatremia
Hypokalemia
Mild Alkalosis
Hypertension
↑ECF Volume
LOW RENIN
Treatment:
Adenoma removal
Adrenalectomy
43
Q

cortisol becomes more soluble in liver and is secreted by the

A

kidneys

44
Q

Aldosterone Regulation

A

Secretion is stimulated by the renin-angiotensin system:
Angiotensin II (direct effect)
High plasma [K+] (direct effect)
ACTH (direct effect)
Hypotension (indirect effect via renin-angiotensin system)

45
Q

desmolase

A

Cholesterol—> Pregnenolone

Catalyzes the reaction

46
Q

Binding of cortisol to ——- in liver renders it more soluble

A

cortisol binding to hydrophilic moiety.

47
Q

Metabolism effects of cortisol on proteolysis, liver glycogenesis and glucagon function

A

increase proteolysis- block aa uptake by muscles.
increase glycogenesis in liver
enhances glucagon function

48
Q

Impact of cortisol on cardiovascular system

A

Cardiovascular system: increases blood pressure and cardiac output. Permissive on the actions of catecholamines – increases beta receptors

49
Q

Three major effects of cortisol

A

energy metabolism
anti-inflammation
anti-stress

50
Q

during normal stress and in combination with inc. cortisol, there is an inc. in epi/norepi secretion from ……

A

sympathoadrenal output

51
Q

largely secrets DHEAS and to lesser extend DHEA

A

Zona Reticularis

52
Q

secrets androstenedione

A

Zona reticularis

53
Q

Secondary effect of aldosterone

A

It increases blood pressure by increased water retention and thus increasing plasma volume.
This effect is secondary to Na+ retention and expansion of the extracellular fluid volume

54
Q

Cushing syndrome causes

A

1- adenoma of ant. pituitary- Large ACTH (cushing’s disease)

2- H. CRH- Abnormal hypothalamus

3- adenoma of adrenal cortex (cushing’s syndrome)

4- latrogenic- side effects of steroid therapy
(cushing’s syndrome)

55
Q

Anti-inflammatory actions of cortisol

5 items

A

stabilizes lysosomes

dec. protease and histamine (red. pain)
dec. cap. permeability
dec. blood flow
dec. immune response

56
Q

Transcortin

A

corticosteroid binding globulin that binds to cortisol

57
Q

AC

A

Adenyl Cyclase

58
Q

3 cortical layers

A

1- Zona Glomerulosa
2- Zona Fasciculata
3- Zona reticularis

59
Q

Primary effect of aldosterone

A

It increases Na+ reabsorption (in) and increases K+ excretion (out) by:
increasing expression and activity of the Na,K- ATPase in the renal tubule cells
increasing activity and expression of epithelial Na+ channels
It increases H+ excretion (out) by the kidney

60
Q

—– effects the cells of the zona fasiculata in short to long term.

Hint: regulation

A

ACTH

61
Q

CYP11A1

A

Desmolase

Medical Physiology (21 decks)

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