Adrenal Glands Flashcards

1
Q

List the 3 parts of the adrenal cortex and what they secrete:

REMEMBER: the deeper you go, the sweeter it gets

A

Zona glomerulosa: mineralcorticoid (aldosterone) –> salt

Zona fasciculata: glucocorticoids (cortisol) –> sugar

Zona reticularis: androgens –> sex

GFR

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2
Q

What is the stimulus that releases cortisol?

A
  1. Stress (physiological and exercise)
  2. Circadian Rhythm
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3
Q

What axis regulates cortisol secretion? Name the players:

A
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4
Q

What is the end goal of cortisol?

A

To increase blood sugar

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5
Q

At what time of day is cortisol secretion in high amounts?

A
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6
Q

What does ACTH affect?

A

Cortisol + Androgens

NOT Aldosterone

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7
Q

What are the symptoms of Cushing’s Syndrome?

A
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8
Q

Cushing’s Syndrome:

A

Adrenal tumor

Increased ACTH

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9
Q

Cushing’s Disease:

A

Pituitary tumor

Decreased ACTH

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10
Q

What test tells you if you have Cushing’s?

A

Low-dose Dexamethasone suppression test

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11
Q

What test tells you what type of Cushing’s you have?

A

High-dose dexamethasone suppression test

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12
Q

How does the high-dose dexamethasone suppression test work?

A

It inhibits ADH,

so if ADH decreases –> Pituitary tumor (negative feedback)

If no change in ADH –> ectopic tumor

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13
Q

Where is ACTH (Adrenocorticotropic hormone) released? What does it contribute to?

A

Anterior Pituitary (POMC)

alpha-MSH –> Melanin Synthesis

Can cause hyperpigmentation

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14
Q

What is a main symptom in Addison’s disease?

A

Hyperpigmentation

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15
Q

What is Addison’s Disease?

A

Decreased cortisol secretion from an autoimmune disease that targets the adrenal gland. It causes CRH and ACTH to increase. The increased ACTH causes herperpigmentation.

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16
Q

What test do you use to detect adrenal gland insufficiency?

A

Cosyntropin (synthetic ACTH) stimulation test

17
Q

Primary adrenal insufficiency:

A

Addison’s

Knocks out adrenal cortex

Decreases cortisol AND aldosterone

18
Q

2 prime and 3 prime adrenal insufficiency:

A

2 (knocks out anterior pituitary)

3 (knocks out hypothalamus)

Decreased ACTH and cortisol

(Aldosterone-renin system not affected)

19
Q

What happens in primary hyperaldosteronism? What syndrome does this produce?

A

Excessive release of aldosterone

Conn’s syndrome –> adenoma in adrenal cortex

20
Q

What happens in secondary hyperaldosteronism?

A

Excessive renin secretion from JGA cells in kidney

21
Q
A
22
Q

How do you detect hyperaldosteronism?

A

PAC (aldosterone) PRA (renin) ratio:

PAC increases

PRA decreases

23
Q

All congenital adrenal enzyme deficiencies are characterized by what?

A

Enlargement of both adrenal glands due to ACTH stimulation

Adrenal Hyperplasia

24
Q

What two enzymes can mess up aldosterone?

A

21 + 11

25
Q

What enzymes can mess up cortisol?

A

All of them

(17, 21, 11)

26
Q

What enzyme can mess up androgens?

A

17

27
Q

What is decreased in 17 alpha?

A

Cortisol

Androgen (sex hormones)

K+

28
Q

What is decreased in 21 beta?

A

Mineralcorticoids (Na+) –> hypotensive

Cortisol

B.P.

29
Q

What is decreased in 11 beta?

A

Mineralcorticoids (aldo)

Cortisol

K+

Renin

30
Q

Why is a pheochromocytoma extremely dangerous?

A

Hypertension

31
Q

What is the function of epinephrine?

A
  1. responds to stress (hypoglycemia/exercise)
  2. Influences energy metabolism + CO
32
Q

What axis controls the synthesis of catecholamines?

A

CRH-ACTH-cortisol axis

33
Q

What enzyme is responsible for degrading catecholamines (Epi/NE)?

A

COMT: catecholamine-O-methyltransferase

34
Q
A