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Endo > Adrenal Module > Flashcards

Adrenal Module Flashcards

1
Q

what does the adrenal cortex produce

these hormones are synthesized from

A
  • aldosterone
  • cortisol
  • androgens
  • cholesterol
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2
Q

what does the adrenal medulla produce

these hormones are synthesized from

A
  • catecholamines

- tyrosine

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3
Q

three layers of the adrenal cortex and what they produce

A
  • zona glomerulosa - aldosterone (mineralocorticoids)
  • zona fasciculata - cortisol (glucocorticoids)
  • zona reticularis - androgens (DHEA, androstenedione)
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4
Q

primary targets of aldosterone

A
  • kidney
  • blood vessels
  • heart
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5
Q

effects of aldosterone

where does this occur

A
  • reabsorb Na+ into blood
  • excrete K+ into urine
  • BP regulation
  • IN RENAL COLLECTING DUCT (PRINCIPAL CELL)
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6
Q

stimulatory factors of aldosterone

inhibitory factors of aldosterone

A
  • AG II
  • high K+
  • low Na+
  • decreased EC fluid volume
  • decreased arterial pressure
  • increased EC fluid volume
  • increased arterial pressure
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7
Q

effects of cortisol

A
  • Appetite (increase)
  • BP (increase)
  • Insulin resistance (increase)
  • Gluconeogenesis (increase) and lipolysis/proteolysis
  • Fibroblast activity (decrease)
  • Immune function (decrease)
  • Bone formation (decrease)
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8
Q

stimulatory factor of cortisol production

how so

inhibitor factor of cortisol production

A
  • ACTH
  • ACTH binds to receptors in fasciculata cells
  • uptakes lipoproteins into fasciculata cells
  • converts cholesterol to pregnenolone
  • cortisol (negative feedback)
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9
Q

effects of androgens (in males/females)

A 
FEMALES
- development of pubic and axillary hair
- contribute to libido
MALES
- bone/muscle growth
- testosterone main androgen which is formed in the testes
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10
Q

stimulatory factor of androgens

how

A
  • ACTH binds to receptors on reticularis cell

- converts cholesterol -> DHEA

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11
Q

effects of catecholamines

A
  • cardiac stimulation

- BP increase

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12
Q

stimulatory factor of catecholamines

A
  • sympathetic fibers (CNS)
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13
Q

synthesis of aldosterone

A
  • cholesterol -> pregnenolone (cholesterol desmolase)
  • pregnenolone -> progesterone (3-B-HSD)
  • progesterone -> 11 deoxycorticosterone (21-B-hydroxylase)
  • 11 deoxycorticosterone -> corticosterone (11-B-hydroxylase)
  • corticosterone -> aldosterone (18-hydroxylase)
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14
Q

synthesis of cortisol

A
  • cholesterol -> pregnenolone (cholesterol desmolase)
  • pregnenolone -> 17-OH pregnenolone (17-hydroxylase)
  • 17-OH pregnenolone -> 17-OH progesterone (3-B-HSD)
  • 17-OH progesterone -> 11-deoxycortisol (21-B-hydroxylase)
  • 11-deoxycortisol -> cortisol (11-B-hydroxylase)
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15
Q

synthesis of androgens

A
  • cholesterol -> pregnenolone (cholesterol desmolase)
  • pregnenolone -> 17-OH pregnenolone (17-hydroxylase)
  • 17-OH pregnenolone -> DHEA (17,20-Des)
  • DHEA -> androstenedione (3-B-HSD)
  • androstenedione -> testosterone (17-B-HSD)
  • testosterone -> estrogen (aromatase)`
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16
Q

synthesis of catecholamines

A
  • tyrosine -> l-dopa
  • l-dopa -> dopamine
  • dopamine -> NE
  • NE-> Epi (enzyme only in adrenal medulla)
17
Q

breakdown product of Dopamine

A
  • homovanillic acid (HVA)
18
Q

breakdown product of NE

A
  • VMA, normetanephrine
19
Q

breakdown product of epinephrine

A
  • metanephrine
20
Q

CV action of dopamine

on which receptor

physiologic response

A
  • vasodilation in heart, kidney, mesentery
  • D1
  • increase blood flow to vascular beds
21
Q

CV action of norepinephrine

which which receptors

physiologic response

A
  • intense vasoconstriction
  • alpha and Beta 1
  • increase PVR
22
Q

CV action of epinephrine

with which receptors

physiologic response

A
  • alpha - vasoconstriction in skin/viscera
  • beta 2 - vasodilation in skeletal muscle
    - stimulation of cardiac muscle cells
  • neutral on PVR
  • increase CO, and HR
23
Q

metabolic effects of catecholamines

A
  • increase glycogenolysis/lipolysis

- decrease insulin release

24
Q

aldosterone and androgens are most commonly measured when _____ secretion is suspected

A
  • excess
25
Q

what tests do you order for adrenal medulla testing

where do you measure them

A
  • catecholamines
  • metanephrines
  • plasma or 24 hour urine
26
Q

what will increase aldosterone before measurement

A
  • low Na diet
  • volume depletion
  • upright posture
27
Q

what will decrease aldosterone before measurement

A
  • high Na diet
  • volume overload
  • supine posture
28
Q

90% of cortisol of bound to

6% of cortisol is bound to

A
  • cortisol binding globulin

- albumin

29
Q

factors that increase CGB

will ____ total measured cortisol

will this affect the urinary or salivary free cortisol

A
  • estrogen containing birth control
  • increase
  • no
30
Q

factors that decrease CBG

will ____ total measured cortisol

will this affect the urinary or salivary free cortisol

A
  • liver dysfunction
  • decrease
  • no
31
Q

cortisol is secreted in a _____ pattern

highest when

and lowest when

A
  • circadian
  • in morning just before waking
  • lowest before sleeping
32
Q

factors that increase catecholamine secretion

under what conditions do we test

A
  • stress, anxiety
  • TCAs, SSRIs, caffeine
  • withdrawal from clonidine, ETOH
  • under calm, controlled conditions without interfering meds
33
Q

for adrenal cortex function, measure

A
  • aldosterone with renin
  • plasma cortisol or 24 hour urine
  • sex steroids
34
Q

which enzyme in aldosterone synthesis is regulated by AGII

A
  • aldosterone synthase

Endo (10 decks)

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