Adrenal Glands

Question 1

Where are the adrenal glands located?

Answer 1

On top of each kidney.

Question 2

What are the two regions of the adrenal glands?

Answer 2

Adrenal medulla (inner) and adrenal cortex (outer).

Question 3

What hormones does the adrenal medulla secrete?

Answer 3

Epinephrine and norepinephrine.

Question 4

What hormones are secreted by the adrenal cortex?

Answer 4

Cortisol, aldosterone, and small amounts of androgens.

Question 5

What is the main glucocorticoid in humans?

Answer 5

Cortisol.

Question 6

What do adrenocorticoids help the body do?

Answer 6

Resist stress and maintain fluid/electrolyte balance.

Question 6

What is the main mineralocorticoid in humans?

Answer 6

Aldosterone.

Question 7

What are two functions of glucocorticoids like cortisol?

Answer 7

Anti-inflammatory and increase during stress.

Question 8

What is the function of mineralocorticoids like aldosterone?

Answer 8

Maintain sodium and water balance.

Question 9

Which hormones are involved in the short-term stress response?

Answer 9

Catecholamines (epinephrine and norepinephrine).

Question 10

What stimulates the adrenal cortex to release hormones during stress?

Answer 10

ACTH (Adrenocorticotropic Hormone) from the pituitary gland.

Question 10

Which hormones are involved in the long-term stress response?

Answer 10

Glucocorticoids and mineralocorticoids.

Question 11

What are the anti-inflammatory and immune effects of cortisol?

Answer 11

Anti-inflammatory and immunosuppressive.

Question 12

How does cortisol affect carbohydrate metabolism?

Answer 12

Stimulates gluconeogenesis in the liver; decreases glucose use in peripheral tissues.

Question 13

How does cortisol affect protein metabolism?

Answer 13

Increases protein breakdown in muscle.

Question 14

How does cortisol affect lipid metabolism?

Answer 14

Promotes lipolysis and causes fat redistribution (moon face, buffalo hump).

Question 15

Which organs does cortisol help protect?

Answer 15

Brain and heart (glucose-dependent organs).

Question 16

What are the effects of cortisol on bone and immunity?

Answer 16

Decreases bone density and resistance to infection.

Question 16

How does cortisol affect insulin and glucagon?

Answer 16

Decreases insulin; increases glucagon.

Question 17

What are the mood effects of cortisol?

Answer 17

Initially elevates mood; chronic use may cause depression.

Question 18

What hormone does the hypothalamus release to start the HPA axis?

Answer 18

CRH (Corticotropin-Releasing Hormone).

Question 18

What does HPA axis stand for?

Answer 18

Hypothalamic-Pituitary-Adrenal axis.

Question 19

What hormone does the pituitary release in the HPA axis?

Answer 19

ACTH (Adrenocorticotropic Hormone).

Question 20

What are stimuli for cortisol release?

Answer 20

Stress, infection, surgery, parturition, cold, exercise.

Question 21

How is cortisol regulated by negative feedback?

Answer 21

Cortisol inhibits CRH and ACTH release.

Question 22

What modulates the HPA axis besides cortisol?

Answer 22

Brain neurotransmitters and immune modulators.

Question 23

What type of hormone is cortisol?

Answer 23

Steroid hormone derived from cholesterol.

Question 24

How is cortisol transported in blood?

Answer 24

Bound to cortisol-binding globulin (CBG).

Question 24

How does cortisol enter cells?

Answer 24

As a free hormone, it crosses the cell membrane.

Question 25

What happens after cortisol binds its receptor?

Answer 25

Hormone-receptor complex enters the nucleus and binds GRE to regulate gene transcription.

Question 26

What condition is caused by excess cortisol?

Answer 26

Cushing’s syndrome.

Question 27

What are the systemic symptoms of Cushing’s syndrome?

Answer 27

Type 2 diabetes, high blood pressure, fat redistribution, osteoporosis, immune suppression, depression.

Question 28

What are causes of Cushing’s syndrome?

Answer 28

Adrenal tumor, pituitary tumor (excess ACTH), long-term corticosteroid use.

Question 29

How is Cushing’s syndrome treated?

Answer 29

Gland removal with hormone replacement or drugs like ketoconazole, metyrapone, osilodrostat.

Question 30

What condition is caused by cortisol deficiency?

Answer 30

Addison’s disease.

Question 31

What are systemic symptoms of Addison’s disease?

Answer 31

Stress/infection susceptibility, low blood glucose, poor fat/protein mobilization, weakness, fatigue, weight loss.

Question 32

What is a hallmark oral symptom of Addison’s disease?

Answer 32

Oral hyperpigmentation (acquired melanosis).

Question 33

What are the causes of Addison’s disease?

Answer 33

Inadequate cortisol production, low ACTH, or abrupt withdrawal from steroids.

Question 34

What is the treatment for Addison’s disease?

Answer 34

Cortisol replacement therapy.

Question 35

What causes oral hyperpigmentation in Addison’s disease?

Answer 35

Low cortisol → ↑ACTH → ↑MSH → bronze pigmentation of oral tissues.

Question 36

What do corticosteroid medications mimic?

Answer 36

Cortisol.

Question 37

How are corticosteroids classified?

Answer 37

By duration of action.

Question 38

What is the duration of short-acting corticosteroids?

Answer 38

8–12 hours.

Question 39

What is the duration of long-acting corticosteroids?

Answer 39

More than 36 hours.

Question 40

What factors influence corticosteroid potency and effect?

Answer 40

Formulation and route of administration.

Question 41

What types of oral diseases are treated with topical corticosteroids?

Answer 41

Non-infectious ulcerative oral diseases like erythema multiforme, lichen planus, and gingivitis.

Question 41

What are the two main therapeutic effects of corticosteroids?

Answer 41

Anti-inflammatory and immunosuppressive.

Question 42

Name three conditions treated with corticosteroids.

Answer 42

Autoimmune disorders (like lupus, rheumatoid arthritis), asthma/bronchospasm, and skin inflammation (e.g., dermatitis).

Question 43

What is the mechanism of topical corticosteroids in the mouth?

Answer 43

Reduce redness, swelling, and inflammation.

Question 44

Name two topical hydrocortisone strengths used in dentistry.

Answer 44

OTC 1% and prescription 2.5%.

Question 44

What are systemic corticosteroids used for in dentistry?

Answer 44

Third molar extraction and pre-prosthetic/reconstructive surgery.

Question 45

What is a commonly used corticosteroid dental paste?

Answer 45

Triamcinolone acetonide dental paste (Kenalog Orabase).

Question 46

Why are corticosteroids not recommended for infectious oral conditions?

Answer 46

They suppress cellular immunity, which is needed to fight infections (e.g., viruses).

Question 47

How is corticosteroid potency chosen for oral use?

Answer 47

Based on the severity of the lesion.

Question 48

What are corticosteroid side effects dependent on?

Answer 48

Dose, duration, and frequency.

Question 49

Name three oral complications of corticosteroids.

Answer 49

Decreased infection resistance, delayed wound healing, and masked infection symptoms.

Question 50

How can corticosteroids affect alveolar bone?

Answer 50

Cause osteoporosis, leading to tooth loss.

Question 51

How can thrush from inhalers be prevented?

Answer 51

Rinse the mouth after inhaler use.

Question 52

What periodontal condition can corticosteroids contribute to?

Answer 52

Periodontal disease.

Question 53

What oral infection is common with inhaled corticosteroids?

Answer 53

Oral candidiasis (thrush).

Question 54

Name four systemic effects of corticosteroids.

Answer 54

Truncal obesity, muscle wasting, fat redistribution, hyperglycemia.

Question 55

What are some catabolic effects of corticosteroids?

Answer 55

Bruising, weakness.

Question 56

What are potential behavioral side effects of corticosteroids?

Answer 56

Euphoria, psychosis, depression.

Question 57

What triggers adrenal crisis in corticosteroid users?

Answer 57

Stress, such as surgery.

Question 58

What causes adrenal crisis in these patients?

Answer 58

HPA axis suppression prevents increased cortisol during stress.

Question 59

What are symptoms of adrenal crisis?

Answer 59

Nausea, vomiting, sweating, weakness, headache, hypotension, hypoglycemia.

Question 60

What are severe signs of adrenal crisis?

Answer 60

Hypothermia, circulatory collapse, death.

Question 61

How is adrenal crisis treated?

Answer 61

Parenteral hydrocortisone and oxygen inhalation.

Question 62

How is adrenal crisis prevented in dental settings?

Answer 62

Administer adrenal steroids before procedures in at-risk patients.