Adrenal Glands

Question 1

3 layers of cortex

Answer 1

Zona glomerulosa
Zona fasiculata
Zona reticularis

Question 2

Carrier protein of aldosterone

Answer 2

Mainly: Serum albumin
(Transcortin)

Question 3

What is released from each layer of adrenal cortex?

Answer 3

Zona glomerulosa: Mineralcorticoid (e.g. Aldosterone)
Zona fasiculata: Glucocorticoid (e.g.
Zona reticularis: Glucocorticoid + Androgens (small amount)

Question 4

What is released from adrenal medulla ?

Answer 4

~80% Adrenaline
~20% Noradrenaline

Question 5

What is Cushing’s syndrome

Answer 5

Chronic excessive exposure to cortisol

Question 6

Excess production of aldosterone

Answer 6

Hyperaldosteronism

Question 7

What causes primary hyperaldosteronism ?

Answer 7

Defect in adrenal cortex

Question 8

What is the most common type of primary hyperaldosteronism ?

Answer 8

Bilateral idiopathic adrenal hyperplasia (cell division)

Question 9

What are the 3 specific causes of primary hyperaldosteronism?

Answer 9

-Bilateral idiopathic adrenal hyperplasia
-Aldosterone secreting adrenal adenoma (Conn’s syndrome)
-Low renin levels

Question 10

What causes secondary hyperaldosteronism?

Answer 10

Over activity of RAAS

Question 11

What are the 3 specific causes of secondary hyperaldosteronism?

Answer 11

-Renin producing tumour (Rare)
E.g. juxtaglomerular tumour

-Renal artery stenosis (pressure)

-High renin levels

Question 12

What are the signs of hyperaldosteronism?

Answer 12

-High BP
-Left ventricular hypertrophy
-Stroke
-Hypernatraemia ( increase in Na+ in blood)
-Hypokalaemia (Decrease in K+ in blood)

Question 13

What are the treatments for secondary hyperaldosteronism ?

Answer 13

Depend on type
-Aldosterone-producing adenomas removed by surgery
-Spironolactone (mineralcorticoid receptor antagonist)

Question 14

Carrier hormone of cortisol?

Answer 14

Transcortin

Question 15

How does cortisol receptor regulate its actions

Answer 15

By regulating gene transcription

Question 16

What are the 6 functions of cortisol

Answer 16

Catabolic effects:
-increased protein breakdown in muscle
-increased lipolysis in fat
-increased gluconeogenesis

-resistance to stress (making vessels more sensitive to vasoconstrictors)
-anti-inflammatory effects
-depression of immune response

Question 17

2 main broad causes of Cushing’s syndrome

Answer 17

External causes
Endogenous causes

Question 18

External cause of Cushing’s syndrome

Answer 18

Prescribed glucocorticoids (Most common)

Question 19

3 endogenous causes of Cushing’s syndrome

Answer 19

-Cushing’s disease
-Adrenal Cushing’s
-Non-pituitary-adrenal tumour

Question 20

What is Cushing’s disease ?

Answer 20

Benign pituitary adenoma secreting ACTH

Question 21

What is Adrenal Cushing’s ?

Answer 21

Excess cortisol produced by adrenal tumour

Question 22

What do non pituitary-adrenal tumours do?

Answer 22

Produce ACTH
E.g.) Small cell lung cancer

Question 23

Signs & symptoms of Cushing’s syndrome

Answer 23

-plethora moon-shaped face
-buffalo hump
-abdominal obesity
-purple striae
-acute weight gain
-hyperglycaemia
-hypertension

Question 24

What includes ‘prescribed glucocorticoids’ ?

Answer 24

Steroid drugs
E.g.) dexamethasone, prednisolone

Question 25

Tests to distinguish between the 3 endogenous causes of Cushing’s syndrome

Answer 25

-ACTH rhythm Test
-Dexamethasone suppression test

Question 26

Which type of Cushing’s disease shows an elevation, drop in ACTH ?

Answer 26

Elevation: Cushing’s disease, non pituitary-adrenal tumour
Drop: Adrenal Cushing’s

Question 27

Which type of Cushing’s syndrome shows a suppressed result for the Dexamethasone suppression test ?

Answer 27

Cushing’s disease

Question 28

What is Addison’s disease ?

Answer 28

Chronic adrenal insufficiency