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Endocrine > Adrenocortical function and dysfunction > Flashcards

Adrenocortical function and dysfunction Flashcards

1
Q

Briefly describe the anatomy/histology of the adrenal gland?

A

Inner medulla: modified sympathetic ganglion

Outer cortex: true endocrine gland

2 endocrine glands of different embryological origin that fused during development

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2
Q

List the hormones secreted from the adrneal gland, including the location from which they are secreted?

A

MEDULLA

Catecholamines

CORTEX

Zona reticularis: sex hormones

Zona fasiculata: glucocorticoids

Zona glomerulosa: mineralocorticoids

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3
Q

Where are glucocorticoids and sex hormones released from?

A

Sex hormones primarily from reticularis, also a little from fasiculata

Glucocorticoids primarily from fasiculata, also a little from reticularis

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4
Q

Describe the pathway for steroid hormone synthesis?

What determines the production of steroid hormones by cells?

A

Cells produce different hormones because they have different enzymes present

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5
Q

Describe the HPA pathway for control of cortisol secretion?

A
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6
Q

Describe the functions of CRH and ACTH, other than that in the HPA axis?

A

Stress related functions in immune and nervous systems

CRH: effects on inflammation and immune response, inhibition of appetite, signlas onset of laboor, linked to mood disorders

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7
Q

What is POMC?

A

Pro-opiomelanocortin

Large protien that yields several bioactive peptides by proteolysis

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8
Q

List some of the bioactive peptides yielded from POMC?

A

Anterior pituitary: ACTH, b-endorphins

Outside pituitary: a-MSH

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9
Q

Describe the effect of a-MSH?

A

Melanocyte-stimulating hormone > decrease food intake and increase skin melanin

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10
Q

How does cortisol protect against hypoglycaemia?

A

Stimulates catabolism of energy stores

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11
Q

How does the action of cortisol relate to glucagon and catecholamines?

A

Cortisol is permissive for the actions of glucagon and catecholamines

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12
Q

Describe the actions of cortisol?

A

Promotes gluconeogenesis in liver

Causes breakdown of skeletal muscle proteins

Enhances lipolysis

Immune suppression

Causes negative calcium balance (decreased absorption, increased excretion, bone breakdown)

Adaptation to stress

Influences brain function

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13
Q

Describe the effect of cortisol on calcium in the body?

A

Causes negative calcium balance, by decreasing absorption, increasing excretion and bone breakdown

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14
Q

Describe the effects of long term cortisol use as a therpaeutic drug?

A

Inhibition of ACTH secretion (negative feedback)

Atrophy of cortisol secreting cells

So, must taper doses gradually

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15
Q

How is cortisol transported in the circulation?

A

Corticosteroid binding globulin

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16
Q

What is the half-life of cortisol?

A

60-90 minutes

17
Q

Describe the factors affecting cortisol release?

A

Circadian rhythm of tonic secretion

Stress enhances release

18
Q

Where is the target receptor for cortisol located?

A

Most tissues

Intracellular (lipophilic)

19
Q

Which disorders are associated with hypersecretion from the adrenal cortex?

A

Hyperaldosteronism

Cushing’s syndrome

Adrenogential syndrome

20
Q

What causes adrenogenital syndrome?

A

Lack enzyme in cortisol steroidogenic pathway > pushes away from cortisol production and towards sex steroid production

21
Q

What are the effects of adrenogenital syndrome?

A

Inappropriate masculinisation in all but adult males

22
Q

How is adrenogenital syndrome treated?

A

Treat with glucocorticoids > repairs glucocorticoid deficit and inhibits ACTH > reduced steroid secretion

23
Q

Which disorders are associated with hyposecretion from the adrenal cortex?

A

Addison’s disease

Adrenal steroid enzyme defects

Cortisol deficiency

24
Q

Describe the hormones associated with the adrenal medulla?

A

Chromaffin cells secrete neurohormones

Catecholamines (adrnealine, NA, dopamine)

25
Q

Why is adrenaline only produced in the adrenal medulla?

A

Enzyme for conversion to adrenaline from NA (PNMT) only present in adrenal medulla

26
Q

Describe the adrenomedullary hormone actions?

A

Fight or flight: increase cardiac rate, contractility, TPR and BP

Metabolic: increase glucose and FFA, increase BMR

Central: increase arousal and alertness

Stess responses

27
Q

Which disorders are associated with hyposecretion from the adrenal medulla?

A

None recognised

28
Q

Which disorders are associated with hypersecretion from the adrenal medulla?

A

Pheochromocytomas

29
Q

Describe the two types of stress and their responses?

A

Acute: fight-or-flight reaction

Chronic: elevates cortisol levels

30
Q

Briefly describe the physiology of a stress response?

A

Endocrine (17 decks)

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