Adrenal Glands Flashcards

1
Q

What type of hormones does the adrenal cortex produce?

A

Steroid hormones

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2
Q

What type of hormones does the adrenal medulla produce?

A

Amine hormones

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3
Q

What are the three layers of the adrenal cortex?

A

Zona glomerulosa, Zona fasciculata, Zona reticularis

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4
Q

What does the zona glomerulosa produce and what is the major hormone secreted?

A

Mineralcorticoids ; aldosterone

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5
Q

What does the zona fasciculata produce and what is the major hormone secreted?

A

Glucocorticoids ; cortisol

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6
Q

What does the zona reticularis produce and what is the major hormone secreted?

A

Sex hormones ; androgens

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7
Q

What is the function of mineralcorticoids?

A

Regulate salt balance

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8
Q

What is the function of glucocorticoids

A

Assist with carbohydrate metabolism

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9
Q

Hat is the function of androgens

A

Required for sexual function but contributes less than the gonads

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10
Q

Function of aldosterone

A

Controls the amount of fluid in the body.
Increases the salt and water conservation via renal tubular retention of Na, Cl, and H2O and promotes the excretion og K and H. Aldosterone results in vasoconstriction which will increase BP and BV

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11
Q

T/F:

Blood levels are higher in the morning

A

TRUE

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12
Q

Adrenal Disease

A

HYPERALDOSTERONISM
- Secreting adrenal adenoma — conn syndrome
- Aldosterone — secreting adrenal carcinoma
- Hyperplasia of adrenal cortex

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13
Q

Reninangiotensin system disorder

A

HYPERALDOSTERONISM
- excess produciton of renin
- malignant hypertension
- renin secreting renal tumor

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14
Q

List some causes of hypoaldosteronism

A
  • Atrophy of adrenal glands
  • Addison’s disease (atrophy with Dec prod of aldosterone and glucocorticoids
  • Congenital deficiency of 21-hydroxylase enzyme
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15
Q

What is the feedback look for cortisol production?

A

Hypothalamus (CRH) -> anterior pituitary (ACTH) -> Cortisol production

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16
Q

Low levels of cortisol ___ the release of ACTH ; high levels of cortisol ___ the release of ACTH

A

Promote ; Inhibit

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17
Q

Cuse of primary hypercortisolism

A

adrenal adenoma or carcinoma

Exogenous administration of cortisol

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18
Q

What type of hypercortisolism is Cushing Syndrome and what is it caused by

A

Primary

Excess cortisol

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19
Q

What causes secondary hypercortisolism

A

Excessive production of ACTH from pituitary tumor

Ectopic production of ACTH by nonendocrine tumor

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20
Q

What type of hypercortisolism is Cushing Disease and what is it caused by

A

Secondary

Pituitary ACTH excess which stimulates excess cortisol production

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21
Q

What are the cases of primary hypocortisolism

A

Atrophy of adrenal gland

Autoimmune disease

TB

Prolonged high dosage cortisol therapy

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22
Q

What is the cause of secondary hypocortisolism

A

Pituitary hypofunction

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23
Q

List the catecholamines

A

Epinephrine (EPI)

Norepinephrine (NE)

Dopamine

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24
Q

Where are catecholamines produced?

A

Tyrosine cells of the medulla, brain, and sympathetic neurons

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25
Q

Function of epinephrine

A

Converts glycogen to glucose

Released in response to low BP, hypoxia, cold exposure, muscle exertion, and pain

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26
Q

Function of norepinephrine

A

Neurotransmitter affecting vascular smooth muscle and heart

Released primarily by the postganglionic sympathetic nerves

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27
Q

Function of dopamine

A

Neurotransmitter in the brain affecting the vascular system

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28
Q

Catecholamine metabolism of DOPAMINE

A

Dopamine > homovanillic acid

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29
Q

Catecholamine metabolism of NOREPINEPHRINE

A

Norepinephrine > normetanephrine > vanillylmandelic acid

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30
Q

Catecholamine metabolism of EPINEPHRINE

A

Epinephrine > metanephrine > vanillylmandelic acid

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31
Q

What is a pheochromocytoma

A

tumor of the adrenal medulla, usually benign

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32
Q

What does a pheochromocytoma cause

A

INC EPI and NE

33
Q

What is a neuroblastoma

A

Malignant tumor of the adrenal medulla that occurs in children

34
Q

What does a neuroblastoma cause

A

Produces EPI, NE, and dopamine. Causes INC HVA and VMA in urinary excretion

35
Q

What are clinical features of pheochromocytoma

A

HTN, paroxysomal with spells of sweating, hyperaldosteronism, or palpitations

36
Q

What are clinical features of Cushing’s syndrome

A

HTN, obesity, weakness

37
Q

What are clinical features of Primary aldosteronism

A

HTN, hypokalemia, weakness

38
Q

What are clinical features of adrenocarcinoma

A

Virilization, HTN, weakness

39
Q

Testes are part of the ____-____-____ axis

A

Hypothalamic - pituitary - gonadal axis

40
Q

LH and FSH are produced by what

A

Anterior pituitary

41
Q

Function of LH in regards to the testes

A

stimulates production of testosterone

42
Q

Function of FSH in regards to the testes

A

stimulates spermatogenesis

43
Q

What controls LH and FSH?

A

GnRH

44
Q

What type of feedback loop is LH and FSH

A

Negative

45
Q

What defines a primary disorder for abnormal synthesis of testosterone

A

Caused by the testes

46
Q

What defines a secondary disorder for abnormal synthesis of testosterone

A

due to primary disorder of the pituitary or hypothalamus

47
Q

Function of testosterone

A

Responsible for development and maintenance of secondary male sex characteristics

48
Q

Hyperandrogenemia is observed in what populations

A

adult males, prepubertal males (precocious puberty), and female children

49
Q

What causes congenital adrenal hyperplasia

A

Enzyme defect of 21-hydroxylase

50
Q

What is observed in congenital adrenal hyperplasia

A

Prevents cortisol production and causes the accumulation of cortisol precursors such as 17-OHP

INC blood 17-OHP and ACTH

DEC blood cortisol

51
Q

Consequences of hypoandrogenemia in adult males

A

Impotence

Loss of secondary sex characteristics

52
Q

Consequences of hypoandrogenemia in prepubertal males

A

delayed puberty

53
Q

Causes of primary hypoandrogenemia

A

Tumors, infections, congenital disorders

54
Q

Example of primary hypoandrogenemia

A

Klinefelter syndrome

55
Q

Causes of secondary hypoandrogenemia

A

primary hypofunction disorders of the pituitary or hypothalamus

56
Q

What is observed in secondary hypoandrogenemia

A

DEC synthesis of LH and FSH

57
Q

What is the chromosomal abnormality observed in Klinefelter Syndrome

A

XXY

58
Q

Within what time frame should a semen analysis be performed

A

within 30 minutes

59
Q

What are the components of a semen analysis

A

pH

Motility

Sperm Count

Sperm Quality (morphology and viability)

60
Q

What axis are the ovaries a part of?

A

Hypothalamic - pituitary - gonadal axis

61
Q

Function of LH in regards to the ovaries

A

Stimulates the production of progesterone at ovulation

62
Q

Function of FSH in regards to the ovaries

A

Stimulates the growth of the ovarian follicles and increases the plasma estrogen level

63
Q

What are the principle female sex hormones

A

Estrogen and progesterone

64
Q

What are the three primary estrogens

A

Estradiol 17b, estrone, estradiol

65
Q

What is the principle estrogen produced by the ovaries

A

Estradiol

66
Q

What is estrogen secreted by

A

ovarian follicles and the placenta during pregnancy (lesser the adrenal glands and testes)

67
Q

What is progesterone secreted by

A

Ovarian follicles and mainly the corpus luteum following ovulation. Also by the placenta during pregnancy

68
Q

Function of estrogen

A

Promotes development and maintains the female reproductive system.

Responsible for the development and maintenance of secondary female sex characteristics

69
Q

Function of progesterone

A

In pregnancy, secreted by the placenta to maintain the uterus

70
Q

Describe the hormone levels of the anterior pituitary during the menstrual cycle

A

FSH is typically at higher concentrations then LH and both peak at 14 days during ovulation

71
Q

Describe the hormone levels of the ovariesduring the menstrual cycle

A

Before ovulation at 14 days, estrogen continues to rise and is at the highest concentration over progesterone and testosterone. It peks at 14 days, drops, and rises and falls in a bell curve with the next peak (not as high as the first) during the luteal phase

Progesterone steadily climbs and then climbs dramatically after ovulation and peaks during the luteal phase above estrogen. Levels fall back to below estrogen at the 28 day mark

Testosterone is in the lowest concentration during the entirety but has a small peak at 14 days

72
Q

Hyperestrinism in females results in

A

Precocious puberty

Infertility and irregular menses

Postmenopausal bleeding

73
Q

Hyperestrinism in males results in what

A

Testicular atrophy and enlargement of breasts

74
Q

Hypoestrinism in females results in

A

Ovarian insufficiency

Delayed puberty

Amenorrhea

Tuner Syndrome (genetic defect in females, loss of one or two X chromosomes)

75
Q

What is the consequencial difference between hyperprogesteronemia and hypoprogesteronemia

A

HYPERprogesteronemia: prevents menstrual cycle from occuring

HYPOprogesteronemia: causes infertility, abortion of fetus

76
Q

What is Polycystic Ovary Syndrome

A

Many cysts in the ovaries

Infertility, hirsutism, chronic anovulation, glucose intolerance, hyperlipidemia, dyslipidemia, hypertension

77
Q

What is hirsutism

A

Abnormal, abundant, androgen sensitive terminal hair growth in areas which terminal hair follicles are sparsely distributed

78
Q

Causes of infertility in females for the following

Hypothalamus:

Pituitary:

Ovaries:

Fallopian Tubes and Uterus:

Conception:

A

Hypothalamus: drugs, INC stress, diet = DEC GnRH

Pituitary: Tumor or vesicular lesion = DEC FSH and LH

Ovaries: Organ failure, organ dysgensis, antiovarian ab, malnourishment = DEC Estradiol and Progesterone

Fallopian Tubes and Uterus: low progesterone output = inadequate endometrium // pelvic inflammation disease = tubal scarring and closure // cervical infections = DEC cervical mucus

Conception: Antisperm ab = immobilization and destruction of sperm

79
Q

Causes of infertility in males for the following

Hypothalamus and Pituitary:

Testes:

Prostate:

Urethrogenetial tract:

A

Hypothalamus and Pituitary: primary defects in hypothalamus or pituitary glands, exogenous androgens, testicular dysfunction = oligospermia to azoospermia

Testes: orchitis = oligospermia to azoospermia // testicular infections = delayed or deficient sexual maturity // alcoholism or substance abuse = DEC testosterone

Prostate: infections of prostate or seminal vesicles = DEC seminal fluid

Urethrogenetial tract: Physical abnormalities and chronic diabetes = retrograde or absent ejaculation