Actions of Glucocorticoids - ___eases gluconeogenesis - ___eases proteolysis (catabolic) - ___eases lipolysis - ___ease glucose utilization - ___ease insulin sensitivity - ___eases GFR - ____eases REM sleep

incr incr incr Decr Decr Incr Decr

21 Beta Hydroxylase deficiency Features: - _______ of females - (early or late?) acceleration of linear growth - (early or late?) appearance pubic and axillary hair - symptoms of deficiency of ____ and _____

viriliZation Early Early glucocorticoid and mineralocorticoid

Adrenal Gland Flashcards by Iseoluwa Ojo

there are 2 endocrine organs in the adrenal gland

(inner or outer?) adrenal medulla secretes __,____,____
(inner or outer?) adrenal cortex secretes ____ hormones

Inner; adrenaline, noradrenaline, dopaminergic

Outer; steroid

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ADRENAL CORTEX
*divided into 3 zones

zona glomerulosa forms __% of the gland . Only one capable of secreting ______ in a significant amount
zona fasciculata forms __% of the gland mass. Secretes mainly _____
zona reticular is forms __% of the gland mass. Secretes mainly ____,____,and____

15 ; aldosterone

75; cortisols

10; adrogens, small estrogens and glucocorticoids

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Zona fasciculata also secretes small Androgens and estrogens
T/F

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MINERALOCORTICOIDS
-aldosterone has 3 actions on the ______ and ______ of the kidney:

increases Na _____ (on _____ cells)
increases K _____ (on _____ cells)
increases H ______ (on ______ cells)

late distal tubule

collecting ducts

reabsorption; principal

secretion; principal

secretion; alpha intercalated

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when aldosterone levels are increased (eg due to _____ tumour), it results in ECF volume (expansion or contraction ?) and (hypotension or hypertension?) , (hypokalemia or hyperkalemia ?) and metabolic (alkalosis or acidosis?)

aldosterone-secreting

expansion ; hypertension ; hypokalemia ; alkalosis

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conversely when aldosterone levels are decreased (eg due to renal insufficiency ), leads to ECF volume (expansion or contraction ?) , (hypotension or hypertension?) , (hypokalemia or hyperkalemia ?), and metabolic (alkalosis or acidosis?)

Contraction

Hypotension

hyperkalemia

Acidosis

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Actions of Glucocorticoids

___eases gluconeogenesis
___eases proteolysis (catabolic)
___eases lipolysis
___ease glucose utilization
___ease insulin sensitivity
___eases GFR
____eases REM sleep

incr

Decr

Incr

Decr

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Glucocorticoids have an inflammatory function

T/F

Anti inflammatory

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Glucocorticoids have an immunosuppressive function

T/F

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Glucocorticoids reduce vascular responsiveness to Catecholamines
T/F

They maintain it

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Glucocorticoids stimulate bone formation

T/F

inhibits

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Regulation of cortisol secretion

controlled entirely by ____
also by other stimuli like any type of ___ or ___ stress

ACTH

mental or physical stress

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ADRENAL ANDROGENS

has (masculinizing or femininizing?) effect
it is (Anabolic or catabolic?)
controlled by ____

masculinizing

Anabolic

ACTH

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Actions of adrenal androgen

In Female: presence of ___ and ____, ____?

In Male: same function as _____

pubic and axillary hair

libido

testosterone

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Abnormalities of adrenal cortex hormones

(1) primary adrenal insufficiency
- _____ disease
- failure of secretion of cortex hormones due to _____ of the cortex
- xtericsed by weight (loss or gain?) , (elevated or depressed ?) ACTH levels, chronically (hypotensive or hypertensive?) leading to ___ (_____ crisis)

Addison’s

atrophy

Loss

elevated

hypotensive

shock

addisonian

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Abnormalities of adrenal cortex hormones

secondary adrenal insufficiency
- _____ disease causing ___ease ACTH secretion

pituitary

Decr

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Abnormalities of adrenal cortex hormones

tertiary adrenal insufficiency : _____ disorder that disrupts ____ secretion

hypothalamic

CRH

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CUSHING’s Syndrome

-prolonged ___ease In plasma cortisol

Incr

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ACTH-dependent Cushing disease due to _____ tumors of the anterior pituitary of Hypothalamus that secretes CRH

-ACTH-independent Cushing disease due to _______ tumor

acth secreting

glucocorticoid-secreting adrenal

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Characteristics of CUSHING’s syndrome

protein (increment or depletion?) due to excess __bolism except in ____ and ___
very (thin or thick ?) skin
muscles (well or poorly?) developed
wounds heal (well or poorly?)

depletion

cata

liver and plasma

Thin

poorly

Poorly

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Characteristics of CUSHING’s syndrome

Generally (thin or thick?) hair but (thin or thick?) hair in face and acne due to _____

thin

Thick

androgen

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Characteristics of CUSHING’s syndrome

fat distribution is such that
*extremities are (thin or thick ?) but fat deposition in face is ___eased ( ____ face)

*__eased upper back ‘_____’

*___eased abdominal wall (_____ abdomen)

Thin

Incr ; Moon

Incr ; Buffalo hump

Incr; pendulus

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21 Beta Hydroxylase deficiency

Features:

_______ of females
(early or late?) acceleration of linear growth
(early or late?) appearance pubic and axillary hair
symptoms of deficiency of ____ and _____

viriliZation

Early

glucocorticoid and mineralocorticoid

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17 alpha hydroxylase deficiency

lack of ___ and ____ in females
symptoms of (excess or deficiency?) of glucocorticoids
symptoms of (excess or deficiency?) mineralocorticods

pubic hair and axillary hair

deficiency

excess

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The adrenal medulla -it’s a (sympathetic or parasympathetic ?) ganglion in which the postganglionic neurons have _______ and become _____ cells -the cells secrete when stimulated by preganglionic nerve fibers that reach the gland through the ______ nerves

sympathetic lost their axons secretory splanchnic

adrenal medullary hormones are essential to life | T/F

F They are not

Adrenal medullary hormones help prepare the individual for ______

emergencies

Physiological effect of catecholamines | -effects are exerted on target tissues by binding to a ____ site on cell membrane influencing the activity of _____

Receptor adenyl cyclase

beta adrenergic agents ___ease cyclic AMP levels while alpha adrenergic agents ___rease it

incr Decr

adrenaline and noradrenaline have both alpha but not beta adrenergic effects T/F

F They have both alpha and beta adrenergic effects

Physiological effect of catecholamines exert metabolic effect - glycogenolysis in ____ and _____ muscles via __-receptor - ___eases mobilization of FFA - ___eases metabolic rate - ___eases force and rate of heart contraction and myocardial excitability

liver and skeletal B Incr Incr Incr

Norepinephrine Elicits vaso_____ through alpha receptor

constriction

epinephrine elicits ____ of blood vessels in liver and muscles via beta-receptor

dilation

Physiological effect of catecholamines increased alertness T/F

Physiological effect of catecholamines cause initial ___ease in plasma K then prolong (rise or fall?) in plasma K as K entry into cell is ___eased

Incr Fall Incr

ACTION OF DOPAMINE - physiological function in circulation is unknown but its injection : * produces renal vaso___ and elsewhere vaso____ * (positive or negative?) inotropic on heart * ___eased systolic BP with __ change in diastolic pressure

dilation constriction positive Incr no

Dopamine is used in treating traumatic and carcinogenic shock T/F

Control of dopamine - under (neural or hormonal?) control - increased secretion is provoked by _____ stimulation causing increased ____ discharge

Neural emergency sympathetic

hyperglycemia is a potent stimulus of dopamine T/F

F Hypo

pheochromocytoma is an hormone secreting tumor that can occur in the adrenal gland T/F

Features of pheochromocytoma - catecholamines ___secretion - ___tension - (reduced or excessive?) sweating

hyper hyper excessive

Features of pheochromocytoma flushing nervousness and weakness Vomiting T/F

T T T

Features of pheochromocytoma palpitations tremor headaches nausea T/F

The adrenal cortex, is of ___dermal origin and has three distinct layers. It composes ___% of the adrenal tissue

meso 80

The adrenal cortex differentiates by gestational week ___ and is responsible for the production of fetal adrenal steroids throughout intrauterine life

Soon after birth, the fetal adrenal cortex begins to ______, eventually ______, and is replaced by the ___-layered adult adrenal cortex.

involute disappears three

The adrenal medulla composes approximately ___% of the tissue.

The adrenal medulla is of _____dermal origin

neuroecto

widest zone of the adrenal cortex is called the zona _____

fasciculata

cholesterol are ___-carbon steroids progesterone are __-carbon steroids the glucocorticoids are __-carbon steroids the mineralocorticoids are __-carbon steroids androgens are __-carbon steroids estrogens are ___-carbon steroids.

21 21 21 21 19 18

Most of the cholesterol is provided to the adrenal cortex via the _____, and small amounts are synthesized by _______ within the adrenal cortical cells.

circulation de novo

Cholesterol circulates bound to ______ ——proteins.

low-density lipo

17 hydroxylase deficiency causes?? 11 hydroxylase deficiency causes?? 21 hydroxylase deficiency causes??

Hypertension Hypertension Virilization

Deoxycorticosterone is 30 times more potent than aldosterone T/F

F 1/30

if the 17α-hydroxylase step is blocked, the zona fasciculata still can’t produce corticosterone T/F

F It can

______ and _____ are drugs that inhibit glucocorticoid biosynthesis.

Metyrapone and ketoconazole

DHEA and androstenedione VS Testosterone Which is more potent?

Testosterone

Adrenal androgens have a ____ group at C___ that distinguishes them from cortisol, aldosterone, and testosterone

ketone 17

Cortisol and aldosterone have ____ at C17 while ____ has a hydroxyl group at C17.

side chains Testosterone

major adrenal androgens can be measured in the urine. T/F

Aldosterone is the only steroid with mineralocorticoid activity T/F

F It’s not

______ and _____ also have mineralocorticoid activity besides also

11-deoxycorticosterone (DOC) and corticosterone

The zonae fasciculata/reticularis, are under the exclusive control of the ______

hypothalamic-pituitary axis

The zona glomerulosa,depends on ACTH for ______, but otherwise it is controlled separately via the ______ system.

the first step in steroid biosynthesis renin-angiotensin-aldosterone

Cortisol is released in a pulsatile manner and nocturnal T/F

F Pulsatile and diurnal

The daily profile of blood cortisol levels is characterized by an average of ___ secretory bursts during a 24-hour period

The lowest secretory rates of cortisol occur during the ____ hours and just (before or after ?) falling asleep and the highest secretory rates occur just (before or after?) awakening in the morning

evening After Before

ACTH __ amino acids Glucagon __ amino acids

39 29

ACTH has a pulsatile and diurnal secretory pattern T/F

Cortisol directly inhibits secretion of CRH from the hypothalamus T/F

Cortisol (directly or indirectly ) inhibits CRH secretion by effects on ____ neurons, which synapse on the hypothalamus.

indirectly hippocampal

Cortisol inhibits the action of CRH on the anterior pituitary, resulting in inhibition of ____ secretion.

ACTH

The dexamethasone suppression test is based on the _____ effects of cortisol on the_____ axis.

negative feedback CRHACTH

Dexamethasone is a synthetic ____

glucocorticoid

Dexamethasone has all of the actions of cortisol excluding the negative feedback effect on ACTH secretion. T/F

F Including

When a low dose of dexamethasone is given to a healthy person, it (stimulates or inhibits?) ___ secretion

Inhibits ACTH

The major use of the dexamethasone suppression test is in persons with _____

hypercortisolism

The dexamethasone suppression test is used to determine whether the hypercortisolism is due to an ______ tumor or a _____ tumor of the adrenal cortex.

ACTHsecreting cortisol-secreting

If the cause of hypercortisolism is an ACTH-secreting tumor of the anterior pituitary, a low dose of dexamethasone ______ cortisol secretion while a high dose of dexamethasone _____ because The __________[_____

does not suppress does tumor’s ACTH secretion is less sensitive to negative feedback by glucocorticoids than is normal anterior pituitary tissue.

If the cause of hypercortisolism is an adrenal cortical tumor, then _____________ cortisol secretion because The ___________

neither low-dose nor high-dose dexamethasone suppresses tumor’s secretion of cortisol is autonomous and is not affected by changes in the ACTH level

ACTH has a tonic effect on aldosterone secretion. T/F

Factors Affecting ACTH Secretion ``` Stress hyperglycemia ADH α-Adrenergic agonists β-Adrenergic agonists Serotonin Opioids ``` Inhibits or stimulates

``` Stimulates Inhibits Stimulates Stimulates Inhibits Stimulates Inhibits ```

Increases in serum K+ concentration increase aldosterone secretion T/F

The adrenal cortex produces the androgenic compounds, _____ and _____ , which are converted to _____ primarily in the testes.

DHEA and androstenedione testosterone

Cushing syndrome vs Cushing disease

Adrenal hyperplasia Excess ACTH

Conn Syndrome ( _______ -Secreting Tumor)

Aldosterone

ACTH levels of Cushing syndrome?

Reduced

Treatment of Cushing disease is ________ Treatment of Cushing syndrome is ________

Surgical removal of ACTH-secreting tumor Ketocanazole Metyrapone

In secondary adreno-cortical insufficiency, ACTH levels are ____

low

Treatment of Conn syndrome consists of administration of an aldosterone antagonist such as ________ followed by ______ of the ______ tumor.

spironolactone surgical removal aldosterone-secreting

Addison's disease ``` ____glycemia weight ____ ____tension ____kalemia Metabolic _____ ____eased pubic and axillaryhair in females ____pigmentation ```

Hypo loss Hypo Hyper acidosis Decr Hyper

Addison's disease causes Anorexia T/F

Addison's disease Causes Weakness T/F

Primary aldosteronism Results from a tumor of the zona ______ resulting in _____ aldosterone

glomerulosa excess

In conn’s syndrome there is ___kalemia Slight ___eased in ECF vol. and blood vol. ____tension

Hypo Incr Hyper