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Principles of Human Health and Disease > Case 4: Running on Empty > Flashcards

Case 4: Running on Empty Flashcards

1
Q

What can hyperpigmentation be caused by? (3)

A

pregnancy, UV exposure, Addison’s Disease

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2
Q

What is p53? What does it do and what can it trigger?

A

Guardian of the Genome
senses DNA and cell health
can suspend proliferation for repair
DNA damage = p53 triggers apoptosis

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3
Q

In response to UV damage, what does p53 do? What does this substance cleave in to?

A

activation of gene which encodes POMC which cleaves into melanin stimulating hormone (MSH)

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4
Q

What does MSH stimulate?

A

stimulates melancortin 1 receptors

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5
Q

What do melancortin 1 receptors trigger?

A

production of 2nd messenger (cAMP)

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6
Q

What does cAMP do?

A

increases transcription of gene for melanin, therefore melanin pigment is produced

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7
Q

Once produced, where is melanin transferred from and to, why and how?

A

from melanocytes to keratinocytes
protect nuclei from DNA damage
via melanosomes

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8
Q

What are the layers of the medulla, cortex (3) and capsule?

A 
adrenal medulla
zona reticularis 
zona fasciculata
zona glomerulosa
capsule
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9
Q

What hormones are secreted from the medulla?

A

catecholamines (eg. adrenaline and noradrenaline)

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10
Q

What hormones are secreted from the zona reticularis?

A

sex hormones (eg. DHEA)

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11
Q

What hormones are secreted from the zona fasciculate?

A

glucocorticoids (eg. cortisol)

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12
Q

What hormones are secreted from the zona glomerulosa?

A

mineralcorticoids (eg. aldosterone)

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13
Q

Peptides: cell receptor site, signaling, soluble, half life, derived?

A 
surface
2nd messenger
water
mins
amino acids
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14
Q

Steroids: cell receptor site, signaling, soluble, half life, derived?

A 
intra
activates genes
lipid
days
cholesterol
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15
Q

Thyroid hormones: cell receptor site, signaling, soluble, half life, derived?

A 
intra
activates genes
lipid
days
iodinated tyrosine
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16
Q

Catecholamines: cell receptor site, signaling, soluble, half life, derived?

A 
surface
2nd messengers
water
mins
tyrosine
17
Q

What are the three categories of adrenal steroids?

A

glucocorticoids
mineralcorticoids
sex steroids

18
Q

What is cortisol? What does it do?

A

glucocorticoid
anti-insulin
decreases glucose uptake
permissive for the actions of catecholamines
vasoconstriction (decrease synthesis of NO)
increases bone reabsorption

19
Q

What is cortisol useful for treating?

A

allergies
autoimmune
transplants

20
Q

What are cortisol levels regulated by?

A 
stress
diurnal rhythm (high in morning due to anti-insulin properties)
21
Q

What does ADH do?

A

conserves water
vasoconstriction
increase calcium influx

22
Q

What triggers aldosterone release?

A

low BP and volume

23
Q

What does aldosterone trigger?

A

increases renin secretion (which then increases angiotensin II which is RAAS system)
increased reabsorption of salt and water

24
Q

Where are sex hormones secreted from? What are they regulated by?

A

zona reticularis

regulated by ACTH

25
Q

What is a primary endocrine dysfunction?

A

problem with gland

26
Q

What is a secondary endocrine dysfunction?

A

problem with under or over secretion of gland from higher pathway

27
Q

What is a primary adrenocortical deficiency due to?

A

Addison’s disease

undersecretion

28
Q

What is a secondary adrenocortical deficiency due to?

A

hypothalamic-pituitary disease

suppression of HPA axis due to chronically elevated steroid levels

29
Q

What tests can be used to diagnose Addison’s disease? (4)

A

Cortisol level test (low)
Auto-antibodies test (adrenal antibodies)
Fasting glucose test (low)
ACTH stimulating test (minimal change after 30 mins)

30
Q

What is an aldosterone deficiency due to?

A

zona glomerulosa not stimulated

31
Q

What is an Addison’s crisis triggered by and what is treatment?

A

stress
injection of hydrocortisone
IV fluids

Principles of Human Health and Disease (5 decks)

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