Adrenocortical Function/Dysfunction Flashcards

1
Q

Does adrenal cortex and medulla form together?

A

Nope. different origin, fused during development

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2
Q

Adrenal cortex is what kind of gland? secretes what in general?

A

true endocrine gland

secretes steroids

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3
Q

adrenal medulla is what kind of gland? secretes?

A

modified sympathetic ganglion secretes neurohormones (catecholamines)

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4
Q

Adrenal cortex, which layers secrete what?

A
  1. Glomerulosa: Aldosterone
  2. Fasciculata: Glucocorticoids
  3. Reticularis: Sex hormomes
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5
Q

Glucocorticoids example?

A

Cortisol

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6
Q

ACTH from anterior pituitary is tropic to which regions in adrenal?

A

Fasciculata

Reticularis

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7
Q

Example of mineralocorticoid?

A

Aldosterone via RAAS and plasma K+

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8
Q

What is produced in reticularis?

A

Androgens
Estrogens
DHEA

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9
Q

What is dehydroepiandrosterone?

A

precursor to androgens

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10
Q

different steroids and chemically related which leads to?

A

cross over effects eg. cortisol and aldosterone

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11
Q

Cortisol negative feedback to:

A

ACTH

CRH

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12
Q

Cortisol does what to immune system?

A

suppresses

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13
Q

Cortisol does what to muscle?

A

protein catabolism

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14
Q

Cortisol does what to adipose tissue?

A

lipolysis

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15
Q

Cortisol does what to liver?

A

gluconeogenesis

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16
Q

CRH not just for cortisol, what else can it mediate?

A

inhibit appetite
signal labour via placenta
mood disorders

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17
Q

What does urocortin do?

A

brain neuropeptide that decreases appetite

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18
Q

POMC is a what?

A

large protein prohormone

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19
Q

POMC stands for?

A

pro-opiomelanocortin

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20
Q

What do you get from POMC in pituitary? 3 things

A
  1. ACTH
  2. y-lipotropin
  3. B-endorphin
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21
Q

What happens to ACTH processing in non-pituitary tissues?

A

creates a-MSH

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22
Q

What is a-MSH? what does it do? 3 things

A

melanocyte-stimulating hormone (melanocortins)

  1. melanin synthesis
  2. immune response
  3. decrease food intake
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23
Q

Cortisol protect you how?

A

protects against hypoglycemia

24
Q

when does cortisol peak? low?

A

Diurnal
peaks in morning
low night

25
Q

Cortisol is permissive for?

A

glucagon

catecholamine

26
Q

Cortisol does what to bone?

A

decrease absorption
increase excretion
bone breakdown

27
Q

Cortisol as drug does what?

A

inhibit inflammatory response

prevent rejection of organ transplant

28
Q

what happens in long term use of Cortisol?

A

inhibition of ACTH scretion and atrophy of cortisol secreting cells

29
Q

When you go off prednisone or Cortisol analogue, how do you do it?

A

taper doses gradually

30
Q

2 kinds of hyperaldosteronism is?

A
  1. primary: Conn’s Syndrome

2. Secondary: RAS

31
Q

What does hyperaldosteronism cause? 3 things

A
  1. hypertension
  2. hypokalemia
  3. hypertension
32
Q

2 kinds of excess cortisol is?

A
  1. Primary: Cushing Syndrome

2. Secondary: pituitary tumour: Cushing’s Disease

33
Q

Adrenogenital syndrome cause?

A

lack of enzyme in cortisol steroidogenic pathway

34
Q

Cushing’s fat deposits where?

A

Face

trunk

35
Q

What are the red purple striate on trunk caused by in Cushing’s?

A

fat deposits

36
Q

Why do you get Moon Face in Cushings?

A

excess glucocorticoid causing more mineralocortocoid action: salt and water retention

37
Q

Adrenal hyposecretion common?

A

Less common than hypersecretion

38
Q

CRH: low
ACTH: low
Cortisol: High

A

Adrenal cortex problem

39
Q

Primary adrenal insufficiency is?

A

Addison’s Disease

40
Q

Addison’s disease is what kind of destruction?

A

Autoimmune destruction of adrenal cortex

41
Q

CRH: low
ACTH: High
Cortisol: High

A

Anterior pituitary problem

42
Q

What hormones affected in Addison’s?

A

Aldosterone K+retention (Cardiac arrhythmias, Na depletion (hypotension)
cortisol

43
Q

Adrenal cortex problem levels of CRH, ACTH, Cortisol?

A

CRH: low
ACTH: low
Cortisol: High

44
Q

If you have lack of adrenal steroid enzymes what can happen?

A

More androgens because no enzymes to make the cholesterol into cortisol or aldosterone

45
Q

CRH: High
ACTH: High
Cortisol: High

A

hypothalamic problem

46
Q

Secondary cortisol deficiency can be causee by?

A

abnormal hypothalamus/pituitary

47
Q

What is made in adrenal medulla?

A

adrenaline

noradrenaline

48
Q

hypothalamic problem levels of CRH, ACTH, Cortisol?

A

CRH: High
ACTH: High
Cortisol: High

49
Q

What cells secrete the neurohormones in the adrenal medulla?

A

Chromaffin cells

50
Q

Anterior pituitary problem levels of CRH, ACTH, Cortisol?

A

CRH: low
ACTH: High
Cortisol: High

51
Q

What are catecholamines?

A

Adrenaline (epinephine)
Noradrenaline (norepinephrine)
Dopamine

52
Q

What is PNMT (Phenylethanolamine-N-methyltransferase)? where is it?

A

Only in adrenal medulla, converts Norepinephrine to epinephrine

53
Q

Backbone molecule in catecholamines are?

A

Tyrosine

54
Q

What does Pheochromocytomas do?

A

Tumour of hypersecretion of catecholamines

55
Q

What is potentially deadly about adrenal medulla hypersecretion?

A

prolong hypertension

56
Q

2 types of stress:

A

Acute

Chronic: cortisol: suppress immune system

57
Q

Why is chronic stress bad?

A

impairs future response to acute or chronic stress