Adrenal Physiology

Question 1

WHich AG layer produces Aldosterone?

Answer 1

Zona Glomerulosa

Question 2

WHich AG layer produces Androgens?

Answer 2

Zona Reticularis

Question 3

WHich AG layer produces Cortisol?

Answer 3

Zona Fasiculata

Question 4

WHich AG layer produces Epinephrine/Norepine?

Answer 4

Adrenal Medulla

Question 5

When is the highest cortisol release? Lowest?

Answer 5

Morning

Middle of the night

Question 6

What is the receptor that ACTH stimulates?

Answer 6

Melanocortin 2 Receptor

Question 7

WHat happens if exogenous Glucocorticoids are removed?

Answer 7

Body takes a while to produce => Death?

Question 8

What happes if 21-Hydroxylase isn’t active?

Answer 8

Androgens increased, Aldosterone and Cortisol decreased
Dec BP
Inc K+
Virilization
Salt wasting 
Precocious puberty

Question 9

What happes if 17-Hydroxylase isn’t active?

Answer 9

Aldosterone is increased, Cortisol and androgens are decreased
Dec K+
Inc BP
Males with ambiguous Genitalia

Question 10

What enzyme converts androstendione to Testosterone?

Answer 10

17B hydroxysteroid dehydrogenase

Question 11

What converts Testosterone to Dihydrotestosterone? What drug inhibits this enzyme?

Answer 11

5 a-reductase

Finasteride(prostate cancer)

Question 12

WHat enzyme converts Androstendione and Testosterones into Estrogens?
What drug inhibits it?

Answer 12

Aromatase

Anastrazole (For Breast Cencer)

Question 13

What transporter brings cholesterol into the mitochondria?

Answer 13

STAR

Question 14

What Enzyme cleaves Cholesterol into Pregnenalone?

Answer 14

p450scc (side chain cleavage)

Question 15

WHat is the pathway for Cortisol production?

Answer 15

Cholesterol 
CHOL DESMOLASE
Pregnanalone
17
17-OH pregnenalone
3B
17-OH progesterone
21
11- Deoxycortisol
11
Cortisol =>
Glucocorticoid Receptor in target tissues

Question 16

What enzyme converts 17-OH pregnenalone to DHEA
AND
17-OH progesterone to Androstenedione?

Answer 16

17-20 Lyase

Question 17

WHat are the effects of Glucocorticoids on the body?

Answer 17

Increased during stress
Increses and maintains blood Glucose
Inc appetite
Inc immune function and inflammation
Catechiolamine permissive 
Reabsorption of Bone
Inc Blood Lipids, and AAs

Question 18

WHat is the Pathway for Aldosterone synthesis

Answer 18

Cholesterol 
CHOL DESMOLASE
Pregnanalone
3B
Progesterone
21
Deoxycorticosterone
11
Corticosterone
11 & Aldosterone Synthase
Aldosterone=>
Mineralocorticoid Receptor in target tissues

Question 19

WHat are the main regulators of Aldosterone response?

Answer 19

Angiotensin II and Elevated Blood K+

Question 20

What does is the renin angiotensin aldosterone pathway?

Answer 20

ATogen
RENIN
AT I
ACE
AT II
Aldosterone

Question 21

What is the role of 11B-HSD 1 and 2?

Answer 21

1 converts Cortisone to Cortisol (activation)

2 Converts Cortisol back to Cortisone (inactivation)

Question 22

What is the difference between 11B OH deficiency and 21 OH deficiency?

Answer 22

DOC increases in 11B Hydroxylase Deficiency
DEC K+
INC BP

Question 23

What is seen on high dose Dexamethasone Supression test in:
Pit Hypersec?
Adrenal Adenoma?
Ectopic ACTH?
Iatrogenic Cushing's Synd?

Answer 23

50% red in cort and ACTH
No reduction in cort/ACTH
No reduction in cort/ACTH
No reduction in cort/ACTH

Question 24

What is the Pathway of Catecholamine Synthesis?

Answer 24

Tyrosine
(TYROSINE OHase)
DOPA
Dopamine
NE
(PNMT)
Epi

Question 25

What Enzyme converts Epi to Metanephrine and NE to Normetanephrine

Answer 25

COMT

catechol-O-methyltransferase

Question 26

What Enzyme Converts NE and Epi to Dihydroxymandelic Acid
AND
Normeta and Meta to Vanillymandelic acid?

Answer 26

MAO

monamine oxidase