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Adrenal Cortex- Hormones, Physiology Flashcards

1
Q

What are steroids made of?

A

Cholesterol from diet, or synthesised within gland

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2
Q

In Zona glomerulosa which enzyme is not present ?

A

17 alpha hydroxylase so can’t make cortisol and androgens

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3
Q

Androgens are synthesised where?

A

Zona reticularis

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4
Q

Cortisol is made where?

A

Zona fasciculata

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5
Q

Secretion of ACTH is … and peak is?

A

Pulsation
Peak early morning
Low in the middle of night.

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6
Q

After how many hours is cortisol peak after ACTH?

A

2

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7
Q

Zona glomerulosa makes?

A

Only aldosterone

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8
Q

What % of cortisol is bound by corticosteroid binding globulin?

A

75%

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9
Q

Pregnancy is associated with?

A

High levels of corticosteroids binding globulin hence an increase in circulation plasma cortisol

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10
Q

What % of cortisol is bound to albumin?

A

15

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11
Q

How do glucocorticoids work?

A

Alter gene expression

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12
Q

Cortisol opposes?

A

Insulin

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13
Q

Cortisol stimulates?

A

Lipolysis and mobilisation of fatty acid, potentiating effects of growth hormone and catecholamines

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14
Q

Excess cortisol?

A

Deposition of fat in novel anatomical sites

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15
Q

In liver cortisol?

A

Amino acid uptake, gluconeogenesis

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16
Q

Excess cortisol is an enhanced?

A

Vasoconstrictor

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17
Q

Glucocorticoids can cause in brain?

A

Elation or sedation

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18
Q

Glucocorticoids affect body’s defence system how?

A

Suppress lymphoid tissue, reduce antibody production and inhibit cellular immune system, stabilise leukocyte membranes and reduce release of proteolytic enzymes
Inhibit phospholipase a2 and reduce synthesis of inflammatory mediators

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19
Q

Antibodies do what to foreign proteins?

A

Inactivates

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20
Q

Tissue repair is enhanced by?

A

Prostaglandins

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21
Q

Cortisol physiological effects?

A

Release of amino acids from muscle causing:

  1. Increase lipolysis
  2. Increase glycogenolysis
  3. Increase glucose
  4. Increase blood pressure
  5. Direct effects on brain and local effects on pain
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22
Q

ACTH stimulates conversion of ?

A

Cholesterol to pregnenolone leading to formation of aldosterone

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23
Q

Secretion of aldosterone is stimulated by?

A

Trauma, anxiety hyperkalaemia and hyponatraemia and inhibited by ANP

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24
Q

What % of aldosterone is protein bound?

25
Sodium reabsorption happens in exchange of?
Potassium or hydrogen ions
26
Aldosterone is unsuitable because?
Short plasma half life so fludrocortisone
27
Glucocorticoids are used for?
Replacement therapy, immunosuppressive and anti-inflammatory effects for arthritis, asthma, allergies or treatment of proliferative conditions such as leukaemia
28
Hydrocortisone?
Oral Bioavailability 60-80% Protein binding High Metabolism Hepatic Half-life Approx 1.5 15-20 mg per day
29
Hydrocortisone adverse effects?
Hyperglycaemia, osteoporosis and Cushing’s syndrome
30
Inhaled glucocorticoids are for?
Asthma/hayfever
31
Topical glucocorticoids are for?
Eczema
32
Oral glucocorticoids are for?
Replacement and immunosuppression
33
Adverse effects of steroid usage?
Suppresses wound healing and may exacerbate infections
34
Long term use of steroids in children?
Inhibit growth and in adults osteoporosis
35
Steroid therapy may be accompanied?
Symptoms of cushings syndrome and development of diabetes mellitus, hypertension
36
Most dangerous adverse effect is?
Suppression of hypothalamic-pituitary axis, atrophy of adrenal cortex
37
Most important part of adrenal gland?
Adrenal cortex
38
If steroid therapy is abruptly stopped, it can lead to?
Addisonian crisis, HPA axis may not respond too
39
Cortex is responsible for?
Stress, sodium and glucose homoestasis?
40
Cushing’s syndrome symptoms?
Thin hair, thin skin, moon face, bruises and cuts, extra hair, supraclavicular fat pads, buffalo hump, thin arms, stretch arms, central obesity, proximal muscle weakness (ask to squat and get up again on their own)
41
Under normal circumstances adrenal cortex secretes small amounts of?
Male sex hormones e.g dehydroepiandrosterone, androstenedione and testosterone, and the female oestrogens eg oestradiol
42
What % of cortisol is in a free active form?
10
43
Metabolism of adrenal steroid in liver causes them to be?
Glucuronidates to form water soluble forms which are excreted in urine
44
Cortisol causes?
Stimulates glycogenolysis and hepatic gluconeogenesis
45
In periphery cortisol causes?
Inhibits amino acid uptake and protein synthesis, net loss of sketch protein
46
Aldosterone sensitive tissues possess?
11 beta hyrdroxysteroid dehydrogenase which converts cortisol to inactive cortisone
47
Mineralocorticoid actions of glucocorticoids are only apparent?
At high concs
48
Main mineralocorticoids?
Aldosterone and 11-deoxycorticosterone
49
Aldosterone secretion is inhibited by what?
Atrial natriuretic peptide
50
Where does aldosterone stimulate reabsorption of sodium?
Distal tube
51
What percentage of adrenal gland is medulla?
10
52
How does metabolism of adrenal steroids happen?
In liver where they are glucuronidates to form water soluble forms which are excreted in urine
53
Which enzyme causes conversion of cortisol to inactive cortisone?
11B hydroxysteroid dehydrogenase
54
Which androgens are produced in reticularis?
Dehydroepiandrosterone Androstenedione Oestradiol Testosterone
55
What percent of cortisol in the blood is free?
10
56
What happens in metabolism of steroids?
Glucuronidated in liver to form water soluble form which are excreted in urine
57
Cortisol opposes insulin?
Antagonises the effects in cellular uptake of glucose Stimulates glycogenolysis And hepatic gluconeogenesis
58
What does cortisol do in periphery?
Inhibits amino acid uptake and protein. Synthesis Results in a net loss of skeletal protein
59
Where does sodium reabsorption happen?
Distal tubule of the kidney, then collecting duct, proximal tubule, ascending loop of Henle and in colon sweat and salivary glands

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