adrenal glands

Question 1

generally describe the adrenal cortex

Answer 1

• outer portion of the adrenal gland
• made of 3 layers
• secrete steroid hormones

Question 2

generally describe the adrenal medulla

Answer 2

• inner portion of adrenal gland
• produces amine hormones

Question 3

where are mineralocorticoids secreted from

Answer 3

zona glomerulosa, outermost cortex layer (G)- 10% of volume

Question 4

where are glucocorticoids secreted from

Answer 4

zona fasciculata, middle cortex layer (F) - 75% of volume

Question 5

where are sex hormones secreted from

Answer 5

zona reticularis, inner layer of cortex (R) - 15% of volume

Question 6

list the function of steroid hormones

Answer 6

• mineralocorticoids: regulate salt balance
• glucocorticoids: assist with carbohydrate metabolism
• androgens: required for sexual function but less so than gonads

Question 7

describe aldosterone

Answer 7

• produced in G zone (outer layer)
• controls salt and water retention
• controlled by RAAS of kidney

Question 8

describe the overall effect of aldosterone

Answer 8

• vasoconstriction to increase BP
• increased sodium retention and potassium excretion, increasing water retention
• overall increases BP and BV

Question 9

describe primary adrenal disease

Answer 9

• aldosterone secreting adrenal adenoma = Conn syndrome

Question 10

desrive secondary hyperaldosteronism

Answer 10

• RAAS disorder produces excess renin

Question 11

describe hypoaldosteronism

Answer 11

• primary = Addison’s disease, atrophy o fadrenal glands w/ depressed production of aldosterone and glucocorticoids
• congenital deficiency of 21-hydroxylase
• decreased secretion of aldosterone and cortisol

Question 12

describe variation of cortisol levels in the body

Answer 12

diurnal variation (ACTH same)

Question 13

list the steps of cortisol regulation

Answer 13

1) hypothalamus (CRH)
2) anterior pituitary gland (ACTH)
3) adrenal glands (cortisol)
- negative feedback loop

Question 14

describe primary hyperadrenalism

Answer 14

adrenal gland misfunction causing increased cortisol release with low ACTH and CRH

Question 15

describe secondary hyperadrenalism

Answer 15

pituitary gland misfunction causing excess ACTH release and subsequent cortisol release
- also referred to as Cushings disease

Question 16

what test can be run to differentiate eptopic tumor vs secondary hypoadrenalism

Answer 16

dexamethasone suppression
- inhibits production of ACTH from pituitary gland

Question 17

what is the difference between cushing’s syndrome and cushings disease

Answer 17

• disease is secondary hyperadrenalism
• syndrome is a general term for cortisol excess

Question 18

describe tertiary hyperadrenalism

Answer 18

hypothalamus misfunction causing excess release of CRH which leads to excess cortisol and ACTH

Question 19

what are catecholamines synthesized from and where

Answer 19

made in adrenal medulla from tyrosine
- include epinephrine, norepinephrine and dopamine

Question 20

describe the function of epinephrine

Answer 20

converts glycogen to glycose for greater work output

Question 21

describe function of norepinephrine

Answer 21

neurotransmitter affecting vascular smooth muscle and heart

Question 22

describe function of dopamine

Answer 22

neurotransmitter in the brain affecting vascular system

Question 23

what is the metabolite of dopamine

Answer 23

homovanillic acid

Question 24

what is the metabolite and final product of norepinephrine metabolism

Answer 24

• normetanephrine metabolite
• vanillylmandelic acid

Question 25

what is the metabolite and final product of epinephrine metabolism

Answer 25

- metanephrine metabolite - vanillylmandelic acid

Question 26

describe pheochromocytoma

Answer 26

a tumor of the adrenal medulla causing increased epinephrine and norepinephrine

Question 27

describe neuroblastoma

Answer 27

tumor of the adrenal medulla (in kids) causing epinephrine, norepinephrine and dopamine excess - increased HVA and VMA urinary excretion (metabolism end products)

Question 28

define adrenal incidentaloma

Answer 28

an adrenal mass > 1 cm discovered via imaging for nonadrenal pathology

Question 29

true or false the testes are a part of the hypothalamic-pituitary-gonadal axis

Answer 29

true

Question 30

how is testosterone related to LH and FSH

Answer 30

LH and FSH are released by anterior pituitary gland and inhibited by increased levels of testosterone

Question 31

describe congenital adrenal hyperplasia (CAH)

Answer 31

caused by 21-hydroxylase deficiency that prevents cortisol production

Question 32

describe hyperandrogenemia

Answer 32

can cause precocious puberty in males and development of male secondary sex characteristic in female children

Question 33

describe primary hypoandrogenemia

Answer 33

called klinefelter syndrome (XXY), decreased amounts of testosterone produced

Question 34

describe secondary hypoandrogenemia

Answer 34

pituitary or hypothalamus disorder causing decreased synthesis of LH and FSH

Question 35

describe estrogen and progesterone impact on LH and FSH formation

Answer 35

estrogen and progesterone have a negetive feeback control on LH and FSH

Question 36

describe estrogen - secretion - differeing forms - principle form

Answer 36

- secreted by ovarian follicles and placenta - estradiol-17beta, esterone and estradiol - estradiol is primary estrogen made by ovaries

Question 37

describe function of progesterone

Answer 37

secreted by corpus luteum after ovulation - increased in luteal phase - decreased in follicular phase

Question 38

what is the role of FSH in the first half of the menstrual cycle

Answer 38

promotes growth of ovarian follicles and increases estrogen

Question 39

how does an increase of estrogen impact LH midcyle

Answer 39

decreases LH and FSH levels (negative feedback)

Question 40

what hormone triggers ovulation

Answer 40

LH

Question 41

what does the follicle become during menstrual cycle

Answer 41

following ovulation the follicle becomes the corpus luteum which produces estrogen and progesterone

Question 42

if there is no fertilization during the menstral cycle what occurs

Answer 42

- lack of hCG (fertilization) causes corpus luteum to degenerate - decreases in estrogen and progesterone

Question 43

what characterizes the follicular phase of menstration

Answer 43

estrogen stimulates growth of uterine lining low levels of progesterone

Question 44

what characterises the luteal phase of the menstrual cycle

Answer 44

progesterone promotes endometrium tissue to accept fertilized egg progesterone measurements are used to confirm ovulation period

Question 45

describe hyperestrinism

Answer 45

causes precocious puberty in females and testicular atrophy in males

Question 46

how can progesterone impact menstrual cycle in increased and decreased levels

Answer 46

- malignant increase prevents menstrual cycle from occurring - malignant decrease causes infertility and abortion of fetus