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PMCOL 343 > corticosteroids and steroid receptors - 1 > Flashcards

corticosteroids and steroid receptors - 1 Flashcards

1
Q

what are the two major classes of corticosteroids

A

glucocorticoids and mineralocorticoids

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2
Q

which is the main endogenous glucocorticoid

A

cortisol

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3
Q

what are 2 main functions for glucocorticoids

A

metabolism

anti-inflammatory

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4
Q

which is the main endogenous mineralocorticoid

A

aldosterone

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5
Q

what are 2 main functions for aldosterone

A

water and electrolyte balane

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6
Q

what controls the secretion of cortisol

A

hypothalamic-pituitary-adrenal HPA axis

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7
Q

what is a diurnal rhythm

A

a pattern of activity based upon a 24-hour cycle, in which there are regular light and dark periods

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8
Q

when does cortisol peak in humans

why

A

early morning (diurnal rhythm)

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9
Q

what are 2 main stimulus for cortisol secretion

A

physical and psychological stressors

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10
Q

what are 4 physical stressors for cortisol secretion

A

heat
cold
injuries
infections

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11
Q

what are 3 psychological stressors for cortisol secretion

A

money
work
relationships

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12
Q

what kind of feedback does cortisol do on the hypothalamus

A

negative

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13
Q

what kind of feedback does cortisol do on the pituitary gland

A

negative

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14
Q

where is cortisol released from

A

adrenal cortex

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15
Q

what causes cortisol release from the adrenal cortex

A

ACTH activation

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16
Q

where is ACTH release

A

anterior pituitary

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17
Q

what negatively inhibits the anterior pituitary from releasing ACTH

A

cortisol

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18
Q

what are the factors released by the hypothamaus that causes ACTH release from the ant pit

A

CRH and AVP

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19
Q

what is CRH and AVP

A

the factors released by the hypothamaus that causes ACTH release from the ant pit

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20
Q

does CRH or AVP play a bigger role in the stress response

A

CRH

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21
Q

what 2 things cause the release of ACTH from the ant pit (and where do they come from)

A

CRH AVP from the hypothalamus

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22
Q

where is the site of synthesis of cortisol (specific)

A

zona fasciculate of adrenal cortex

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23
Q

what is the starting substance of cortisol

A

cholesterol

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24
Q

what G protein does ACTH act through

A

Gs (adenylate cyclase)

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25
Q

what is the rate limiting step of cortisol synthesis

A

conversion of cholesterol to pregnenolone

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26
Q

how is cortisol relased from the adrenal cortex

A

diffusion across plasma

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27
Q

why can cortisol just diffuse out of the adrenal cortex

A

because its highly lipid soluble (made from cholesterol)

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28
Q

what 2 things can plasma cortisol bind to

A

albumin and corticosteroid-binding globulin (CBG)

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29
Q

what does CBG stand for

A

corticosteroid-binding globulin

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30
Q

what does corticosteroid-binding globulin do

A

binds only to natural cortisosteroids

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31
Q

what does albumin do

A

binds to both natural and synthetic cortisol

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32
Q

what 2 things cause an increase in CBG (corticosteroid-binding globulin) levels

A

estrogen

hyperthyroiddism

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33
Q

what 2 things cause a decrease in CBG (corticosteroid-binding globulin) levels

A

hypothyroidism

protein deficiency

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34
Q

what happens with cortisol with high estrogen levels and why

A

less plasma cortisol because more is bound by CBG

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35
Q

what happens with cortisol with hyperthyroidism and why

A

less plasma cortisol because more is bound by CBG

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36
Q

what happens with cortisol with hypothyroidism and why

A

more plasma cortisol because less is bound by CBG

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37
Q

what happens with cortisol with protein deficiency and why

A

more plasma cortisol because less is bound by CBG

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38
Q

what binds to both natural and synthetic cortisol

A

albumin

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39
Q

what binds to only natural cortisol

A

CBG (corticosteroid-binding globulin)

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40
Q

what is the overall effect of glucocorticoids on sugar levels

A

increase sugar levels in blood so that theres adequate supply of glucose to the brain

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41
Q

what do glucocorticoids do to glucose uptake in skeletal muscle

A

decreases

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42
Q

what do glucocorticoids do to glucose use in skeletal muscle

A

decrease

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43
Q

what do glucocorticoids do to gluconeogenesis

A

increase

44
Q

what do glucocorticoids do to insulin

A

increases secretion

45
Q

why do glucocorticoids increase insulin secretion

A

because there is a rise in plasma glucose

46
Q

what do glucocorticoids do to protein breakdown

A

increase

47
Q

what do glucocorticoids do to protein synthesis

A

decrease

48
Q

where does glucocorticoids have a catabolic effect

A

lymphoid, connective tissue, muscle, skin and bone

49
Q

what do glucocorticoids do to lipolysis

A

increase

50
Q

what do glucocorticoids do to lipogenesis and why

A

increase due to insulin secretion

51
Q

what does insulin do to lipogenesis

A

increase

52
Q

what is the overall effect of glucocorticoids on fat

A

increases fat deposition

53
Q

if cortisol causes lipolysis, why does fat deposition occur

A

cortisol causes lipolysis
but insulin causes lipogenesis
so in this case lipogenesis wins

54
Q

what do glucocorticoids do to # of immune cells

A

decreases

55
Q

what do glucocorticoids do to macrophage functions

A

inhibits

56
Q

what do glucocorticoids do to fibroblast functinos

A

decreases

57
Q

what do glucocorticoids do to cytokine production and actions

A

decrease

58
Q

what do glucocorticoids do to IgG production

A

decrease

59
Q

what do glucocorticoids do to blood vessels

A

decrease in vasodilation

60
Q

what do glucocorticoids do to histamine release from mast cells and basophils

A

decrease

61
Q

what do glucocorticoids do to CRH and ACTH secretion

A

inhibition via negative feedback

62
Q

what does ACTH do to adrenal cortex

A

maintenance, including making sure theres no atrophy

63
Q

what do glucocorticoids do to adrenal cortex

how

A

causes atrophy

reduce ACTH levels so a decrease in size of adrenal cortex

64
Q

what do glucocorticoids do to blood vessel size

A

vasoconstriction

65
Q

what do glucocorticoids do to BP

A

increase

66
Q

what do glucocorticoids do to vascular responsiveness (and to what)

A

increased responsiveness to angiotensin2 NA A

67
Q

what do glucocorticoids do to Ca++

A

negative Ca++ balance

  • decreased Ca++ uptake via GI
  • increased kidney Ca++ excretion
68
Q

what do glucocorticoids do to musculoskeletal system

A

decreased osteoblast activities, increased osteoclast activities

69
Q

what do glucocorticoids do to behaviour initially

A

insomnia, euphoria

70
Q

what do glucocorticoids do to subsequently (not initially)

A

depression

71
Q

what is excessive cortisol linked to

A

major depressive disorders

72
Q

what are 5 symptoms of decreased cortisol levels

A
  • muscle weakness
  • fatigue
  • weight loss
  • hypotension
  • fasting hypoglycemia
73
Q

what are 3 symptoms of decreased aldosterone levels

A

dehydration
hyponatremia
hyperkalemia

74
Q

what can cause acute adrenocortical insufficiency

A

abrubt withdrawal of exogenous glucocorticoid after prolonged therapy

75
Q

how long can adrenocortical insufficiency from exogenous glucocorticoid recovery take

A

several months

76
Q

what is addisons disease

A

chronic adrenocortical insufficiency

77
Q

what can cause addisons disease

A

autoimmune, infection, cancer, congenital unresponsiveness to ACTH

78
Q

why does fasting hypoglycemia happen with adrenocortical insufficiency

A

cortisol usually stops sugar uptake into cells, so with less cortisol, there will be low plasma sugar

79
Q

what causes congenital adrenal hyperplasia

A

lack of 21β-hydroxylase

80
Q

what happens in congenital adrenal hyperplasia (what is affected)

A
  • reduction in cortisol and aldosterone synthesis
  • increased ACTH (less -ve feedback)
  • increased androgens and estrogen
81
Q

what happens to cortisol with congenital adrenal hyperplasia

A

levels reduce

82
Q

what happens to aldosterone with congenital adrenal hyperplasia

A

less synthesis

83
Q

what happens to ACTH with congenital adrenal hyperplasia and why

A

more because less negative feedback

84
Q

what happens to androgen with congenital adrenal hyperplasia + why

A

increase because more androstenedione

85
Q

what happens to estrogen with congenital adrenal hyperplasia + why

A

increase because more androstenedione

86
Q

which pathway is favorted with 21β-hydroxylase defect and why

A

sex steroid pathway because 21β-hydroxylase works mostly in the mineralocorticoid and glucocorticoid pathways

87
Q

what metabolite becomes excess with 21β-hydroxylase defect

A

androstenedione

88
Q

what is the main thing that 21β-hydroxylase metabolizes

A

progesterone

89
Q

what characterises cushings disease

A

high plasma level of cortisol

90
Q

what causes cushings disease (3)

A

pituitary adenoma (tumor)
nodular hyperplasia of adrenal gland
ectopic production of ACTH by other tumor (not in pit)

91
Q

what is required after surgical removal in cushings disease

A

glucocorticoid replacement

92
Q

in cushings disease, what would an adrenal or pituitary gland tumor release

A

adrenal-cortisol

Pituitary-ACTH

93
Q

what is the diagnostic test called for cushings disease

A

dexamethasone suppression test

94
Q

how do you do the dexamethasone suppression test

A

administer dexamethasone at night, measure plasma cortisol level

95
Q

what would indicate a cortisol producing tumor with the dexamethasone suppression test

A

high cortisol and low ACTH

96
Q

what is dexamethasone

A

a synthetic cortisol

97
Q

what would indicate a ACTH producing tumor with the dexamethasone suppression test

A

high cortisol and high ACTH

98
Q

what would high cortisol and low ACTH mean with a dexamethasone suppression test

A

cortisol producing tumor

99
Q

what would high cortisol and high ACTH mean with a dexamethasone suppression test

A

ACTH producing tumor

100
Q

where are 2 places that an ACTH producing tumor could be

A

in pituitary or lungs

101
Q

where is 1 place that a CORTISOL producing tumor could be

A

in adrenal glands

102
Q

why would there be high cortisol and low ACTH with a dexamethasone suppression test in a CORTISOL producing tumor

A

because adrenal tumor makes cortisol so theres negative feedback so low ACTH

103
Q

what are 2 clinical uses for glucocorticoids

A

diagnostic test (cushings disease ) or lung maturation

104
Q

what does cortisol do to lungs

A

regulates lung maturation in fetus

105
Q

why can cortisol be used therapeutically for lungs (and for who)

A

immature lung development in fetuses because cortisol regulates lung maturation in fetus

106
Q

what can cause immature lung development in fetuses

A

low maternal cortisol or early birth

107
Q

what can cortisol administration do to infants with resp issues

A

reduce incidence of respiratory distress

PMCOL 343 (31 decks)

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