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Year 2 Endocrine > Adrenal physiology > Flashcards

Adrenal physiology Flashcards

1
Q

zona glomerulosa: product

A

aldosterone

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2
Q

zona fasciculata: product(s)

A

cortisol

some androgens

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3
Q

zona reticularis: product(s)

A

androgens

some cortisol

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4
Q

ACTH binds to what receptor?

A

MC2R

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5
Q

which enzyme is responsible for cleaving cholesterol? what is the product?

A

cholesterol desmolase

pregnenolone

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6
Q

what are the biosynthetic products of mineralocorticoid synthesis?

A 
cholesterol 
pregnenolone 
progesterone 
DOC 
corticosterone 
18-OH corticosterone 
aldosterone
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7
Q

what are the biosynthetic products of glugocorticoid synthesis?

A 
cholesterol 
pregnenolone 
17-OH pregnenolone 
17-OH progesterone 
11-deoxycortisol 
cortisol
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8
Q

what are the biosynthetic products of androgen synthesis?

A 
cholesterol 
pregnenolone 
17-OH pregnenolone 
DHEA 
androstenedione 
testosterone (formation occurs in testes)
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9
Q

what is the rate limiting conversion step of glucocorticoid biosynthesis?

which enzyme is this?

A

conversion of cholesterol into pregnenolone

cholesterol desmolase

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10
Q

what enzyme allowed formation of DHEA from 17-OH pregnenolone?

A

17a hydroxylase

17-20 lyase

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11
Q

which enzyme is responsible for converting DHEA to androstenedione?

A

3B-hydroxysteroid dehydrogenase

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12
Q

ACTH affects which rate limiting step of glucocorticoid synthesis?

A

cholesterol desmolase

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13
Q

how does cortisol maintain and increase plasma glucose levels?

A
  • increased gluconeogenesis

- decreased glucose use by most cells

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14
Q

which compounds have ‘slight’ mineralocorticoid activity?

A

11-deoxycorticosterone (DOC)

corticosterone

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15
Q

which synthetic mineralocorticoid is used to treat primary adrenal insufficiency?

A

fludrocortisone

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16
Q

regulation of aldosterone synthesis

A
  • angiotensin II binds AII-receptor in zone glomerulosa cells - increase in intracellular calcium leads to increase in expression of StAR and cholesterol desmolase
  • elevated blood potassium depolarizes zona glomerulosa cells increases intracellular calcium
17
Q

functions of aldosterone

where are the mineralocorticoid receptors?

A
  • maintain sodium, potassium, and water (blood volume) balance
  • conserve sodium during sweating
  • prevents loss of sodium in stool
  • distal convoluted tubule and collecting ducts, distal colon, sweat glands, salivary gland epithelial cells
18
Q

what is AME? what is the cause? why does this occur?

A

apparent mineralocorticoid excess - rare genetic disease

caused by inactivation of 11B-HSD2

cortisol can bind mineralocorticoid receptor

19
Q

what is the physiological importance of 11B-HSD type 1 and 11B-HSD type 2?

A
  • 11B-HSD1 converts cortisone (inactive) to cortisol (active)
  • 11B-HSD2 converts cortisol (active) to cortisone (inactive)
  • 11B-HSD1 is abundant in liver, adipose tissue, brain, and lung
  • 11B-HSD2 is abundant in kidney, colon, salivary glands
20
Q

hypercortisolism can lead to saturation of what enzyme?

A

11B-HSD2

21
Q

17a-hydroxylase deficiency: high or low?

mineralocorticoids 
potassium 
cortisol 
androgens 
BP
A 
HIGH mineralocorticoids 
LOW potassium 
LOW cortisol 
LOW androgens 
HIGH BP
22
Q

what is the diagnostic test / lab seen in 17a-hydroxylase deficiency?

A

increased 17-OH progesterone

23
Q

what is the presentation for 17a-hydroxylase deficiency?

A
  • XY: ambiguous genitalia, undescended testes, virilize inadequately at puberty
  • XX: lack secondary sexual development
24
Q

21-hydroxylase deficiency: high or low?

mineralocorticoids 
potassium 
cortisol 
androgens 
BP
A 
LOW mineralocorticoids 
HIGH potassium 
LOW cortisol 
HIGH androgens 
LOW BP
25
Q

what is the presentation for 21-hydroxylase deficiency?

A
  • XX infants can have male genitalia (virilization)
  • salt wasting crisis
  • precocious puberty
26
Q

11B-hydroxylase deficiency: high or low?

mineralocorticoids 
deoxycorticosterone (DOC) 
potassium 
cortisol 
androgens 
BP
A 
LOW mineralocorticoids 
HIGH deoxycorticosterone (DOC) 
LOW potassium 
LOW cortisol 
HIGH androgens 
HIGH BP
27
Q

11B-hydroxylase deficiency: presentation

A

virilization

28
Q

high dose dexamethasone test: ACTH and cortisol response in:

pituitary hypersecretion of ACTH

A

50% reduction in ACTH and cortisol

29
Q

high dose dexamethasone test: ACTH and cortisol response in:

adrenal adenoma

A

no reduction in cortisol or ACTH

30
Q

high dose dexamethasone test: ACTH and cortisol response in:

ectopic ACTH production

A

no reduction in cortisol or ACTH

31
Q

high dose dexamethasone test: ACTH and cortisol response in:

iatrogenic Cushing’s syndrome

A

no reduction in cortisol or ACTH

32
Q

what enzyme converts tyrosine to DOPA?

A

tyrosine hydroxylase (rate limiting)

33
Q

what enzyme converts NE to EPI?

A

PNMT

34
Q

what converts EPI to metanephrine?

A

COMT

35
Q

what converts NE to normetanephine?

A

COMT

Year 2 Endocrine (33 decks)

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