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Endocrinology > adrenal gland > Flashcards

adrenal gland Flashcards

1
Q

position of adrenals?

A

lies on superior pole of kidney in retroperitoneal space

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2
Q

weight go each adrenal?

A

~4g

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3
Q

2 parts of adrenal gland?

A

adrenal cortex

adrenal medulla

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4
Q

% of medulla v.s. cortex

A

medulla - 25%

cortex - 75%

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5
Q

adrenal medulla - what is it?

A

a modified sympathetic ganglion - i.e. neuroendocrine gland

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6
Q

where does adrenal medulla secrete hormones?

A

postganglionic cell

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7
Q

which hormones are secreted from adrenal medulla?

A

epinephrine mainly, also norepinephrine and dopamine

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8
Q

how is the adrenal cortex ascribed and what does it secrete?

A

true endocrine gland -

secretes - mineralocorticosteroids, glucocorticosteroids, sex steroids

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9
Q

examples of -
1 - mineralocorticoids
2 - glucocorticoids
3 - sex steroids

A

1 - aldosterone
2 - cortisol
3 - testosterone

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10
Q

describe layers of adrenal gland from the outside in

A 
OUTSIDE - 
capsule
zone glomerulosa (CORTEX)
zone fasciculata (CORTEX)
zone reticularis (CORTEX)
medulla 
INSIDE
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11
Q

which hormones are produced from the three layers of the adrenal cortex?

A

zone glomerulosa - aldosterone
zone fasciculata - glucocorticoids
zone reticularis - sex hormones

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12
Q

common cause of congenital adrenal hyperplasia?

A

defects in 21-hydroxylase

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13
Q

result of congenital adrenal hyperplasia?

A

deficiency in aldosterone and cortisol, associated with disruption of salt and GLC

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14
Q

Why does a deficit in 21-hydroxylase cause adrenal hyperplasia?

A

lack inhibits synthesis of cortisol

  • > removes -ve feedback on ACTH and CRH release
  • > increased ACTH secretion
  • > enlargement of adrenal glands
  • > -ve feedback on ACTH on CRH synthesis remains
  • > sick babies
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15
Q

how much cortisol is bound to a carrier protein?

A

~95%

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16
Q

what is this carrier protein?

A

CBG - cortisol binging globulin

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17
Q

what does cortisol do?

A

influence GLC metabolism

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18
Q

where are steroid hormone receptors found in the cell?

A

cytoplasm, membrane or nucleus

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19
Q

peak plasma cortisol conc vs lowest?

A

peak - ~6-9am

lowest - ~midnight

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20
Q

what are fluctuations of cortisol conc during the day related to?

A

stress and other related stimuli

21
Q

an effect of loss of cortisol in animals?

A

inability to deal with stress, especially maintaining BG levels
also inability to maintain ECF volume

22
Q

another crucial role of cortisol?

A

protecting the brain from hypoglycaemia - due to permissive action on glucagon - i.e. they work together

23
Q

4 actions of cortisol on GLC metabolism?

glucocorticoid action

A

gluconeogenesis
proteolysis
lipolysis
decrease in insulin sensitivity

24
Q

how would you describe the role of cortisol re insulin?

A

it opposes the action of insulin -

excess cortisol is diabetogenic

25
Q

4 further actions of cortisol? (non-glucocorticoid action)

A

-ve effect on Ca2+

depression and cognitive impairment

permissive effects on norepinephrine

suppression of immune system

26
Q

what is the condition presenting as hypercortisolaemia and what is its effect on BP?

A

Cushing’s Disease -

associated with hypertension

27
Q

association of hypocortisolaemia and BP?

A

associated with hypotension

28
Q

3 side effects of glucocorticoid therapy?

A

muscle wastage

increased severity amp frequency of infection

thinning of and fragile skin

29
Q

risk related to withdrawing chronic glucocorticoid treatment too quickly?

A

atrophy of adrenal gland resulting in ADRENAL INSUFFICIENCY

30
Q

function of aldosterone?

A

acts on the distal tubule of the kidney to determine the levels of minerals reabsorbed/excreted

31
Q

type of hormone - aldosterone?

A

mineralocorticoid

32
Q

which pathway controls the secretion of aldosterone?

A

RAAS - renin-angiotensin-aldosterone system

33
Q

effects of increased aldosterone?

A

stimulates Na+ (and H2O) retention and K+ depletion, resulting increased blood volume and increased blood pressure

34
Q

effects of decreased aldosterone?

A

Na+ (and H2O) loss and increases [K+]plasma, resulting in diminished blood volume and decreased blood pressure.

35
Q

hypersecretion of cortisol, causing Cushing’s, is due to what?

A

tumour in adrenal cortex (1y hypercortisolism)
OR…
tumour in pituitary gland (2y hypercortisolism)

36
Q

1y hypercortisolism - result?

A

cushings SYNDROME

37
Q

2y hypercortisolism - result?

A

cushings DISEASE

38
Q

iatrogenic hypercortisolism?

A

therapeutic administration of cortisol errors

39
Q

hyposecretion is less common - what is the result?

A

Addison’s disease

40
Q

what is Addison’s a result of?

A

Hyposecretion of all adrenal steroid hormones due to autoimmune destruction of adrenal cortex

41
Q

presentation of Cushing’s disease?

A

wasting of extremities and limbs, redistribution of fat to face (moon face) and trunk

42
Q

which hormones are secreted as a result of stress?

A

CRH

ACTH

43
Q

alcohols effect on CRH and ACTH?

A

it increases the secretion of these hormones

44
Q

what is the result of an increase of ACTH and CRH?

A

elevation of cortisol

  • > suppressing immune system
  • > increases vulnerability to infection
45
Q

how are hormones released by the postganglionic fibres in the adrenal medulla?

A

directly into blood - bc they do not have axons

46
Q

tumour of the adrenal medulla and its effect?

A

Pheochromocytoma - results in excess catecholamines

47
Q

result of excess catecholamines?

A

increase in HR

  • > increase in CO
  • > sig. increases BP
48
Q

how is Pheochromocytoma described due to its effect on GLC metabolism?

A

diabetogenic

49
Q

treatment for Pheochromocytoma?

A

surgery

Endocrinology (21 decks)

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