Adrenal Gland Fx And Diseases - 2/9 Lopez

Question 1

A defect in 17a-hydroxylase results an increased production in what?

Answer 1

Aldosterone

Question 2

A deficiency in 21B-hydroxylase results in what?

Answer 2

Directs the system towards androgen production

Question 3

Deficit in 11B-hydroxylase results in what?

Answer 3

Directs system towards Androgens

Question 4

How do steroid hormones work?

Where are the receptors located?

Slow or fast acting?

Answer 4

Lipophilic, easily cross CM

Cytoplasm or nucleus

Slow

Question 5

What does ACTH contain?

What does it do?

Answer 5

alpha-MSH

Melanin synthesis

Question 6

What are the target tissues of cortisol?

Answer 6

LIAM

Liver, immune system, adipose, muscle

Question 7

What effect does cortisol have on the following?

Liver
Immune system
Adipose
Muscle

Answer 7

Gluconeogenesis
Immune suppression
Lipolysis
Protein catabolism

Question 8

When are secretory rates of cortisol high?

Low?

Answer 8

In the morning

Night/midnight

Question 9

Exogenous cortisol may cause what with prolonged exposure?

Answer 9

Atrophy of the adrenal cells

Question 10

Cushing’s syndrome is caused by what?

Results in what?

Answer 10

Adrenal tumor

Hypercortisolism

Question 11

What is Cushing’s disease?

Result?

Answer 11

Tumor in pituitary gland

Hypercortisolism

Question 12

What is Addison’s disease?

Causes what?

Answer 12

Autoimmune disease of adrenal gland

Hypocortisolism

Question 13

In Hypocortisolism cortisol levels are low, what does this mean regarding CRH and ACTH levels?

Answer 13

Elevated because it detects low levels of cortisol

Question 14

What causes secondary adrenal insufficiency?

Answer 14

Glucocorticoid drugs

Question 15

When does hyper pigmentation result?

Answer 15

When ACTH levels are elevated (secondary/pituitary excess and primary deficiency)

Question 16

Describe the levels of the following in Cushing’s Syndrome

CRH
ACTH
Cortisol

Answer 16

DEC
DEC
INC

Question 17

Describe the levels of the following in Cushing’s disease

CRH
ACTH
Cortisol

Answer 17

DEC
INC
INC

Question 18

Describe the levels of the following in Addison’s Disease

CRH
ACTH
Cortisol

Answer 18

INC
INC
DEC

Question 19

Describe the levels of the following in Secondary adrenal insufficiency

CRH
ACTH
Cortisol

Answer 19

DEC
DEC
DEC

Question 20

What kind of receptor does aldosterone have?

Answer 20

Cytoplasmic receptor

Will translocate to nucleus to initiate transcription

Question 21

What causes primary hyperaldosteronism?

Answer 21

Excessive secretion of aldosterone from adrenal cortex

Question 22

What causes secondary hyperaldosteronism?

Answer 22

Excessive secretion by the JG cells of the kidney

Question 23

What is Conn’s syndrome?

Answer 23

Adenomas in the adrenal cortex, primary hyperaldosteronism

Question 24

What causes hypoaldosteronism?

Answer 24

Destruction of adrenal cortex
Defects in aldosterone synthesis
Inadequate stimulation of aldosterone secretion

Question 25

What are the clinical Sx of Addison's disease? Result of what?

Answer 25

Weakness, weight loss, hyperpigmentation Primary deficiency of cortisol and aldosterone due to atrophy of adrenal cortex

Question 26

Describe the synthesis of epinephrine

Answer 26

Tyrosine -> dopa -> dopamine -> NE -> epinephrine

Question 27

Synthesis of NE -> Epi via what enzyme? What stimulates production?

Answer 27

PNMT Cortisol

Question 28

Where is NE synthesized in chromaffin cell? Epi?

Answer 28

Within the chromaffin granule Cytosol

Question 29

What is the RLS of epinephrine synthesis? Give substrate, product, enzyme

Answer 29

Try -> L-dopa | Via enzyme Tyrosine hydroxylase

Question 30

How is Epi transported from the cytosol to the granule?

Answer 30

VMAT

Question 31

What are NE and Epi complexed with in the granule?

Answer 31

ATP, Ca, chromogranins

Question 32

Epi can be broken by what enzymes? What is the ultimate breakdown product that can be measured in the urine?

Answer 32

COMT, MAO VMA

Question 33

What receptor does epinephrine have higher affinity that NE for?

Answer 33

Beta-2

Question 34

What is pheochromocytomas? Sx?

Answer 34

Tumor of chromaffin tissue Produces excess catecholamines Headaches, sweating, palpitation, hypertension

Question 35

What regulates the activity of cholesterol desmolase? What does it regulate?

Answer 35

steroids genie acute regulatory protein (StAR) Cholesterol transport transfer within the mitochondria