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Endocrine > Cortisol > Flashcards

Cortisol Flashcards

1
Q

Where are the adrenal glands located

A

on the superior pole of the kidney in the retroperitoneal space

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2
Q

What are the two main parts of the adrenal gland

A 
Adrenal cortex (75%)
Adrenal Medulla (25%)
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3
Q

What type of gland is found in the adrenal medulla

A

A modified sympathetic ganglion (neuroendocrine gland).

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4
Q

What does the adrenal medulla secrete

A

Secretes catecholamines, mainly epinephrine (adrenaline) but also norepinephrine and dopamine (in smaller amounts)

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5
Q

What type of gland is found in the adrenal cortex

A

A true endocrine gland

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6
Q

What classes of hormone does the adrenal cortex secrete

A

Mineralocorticoids
Glucocorticoids
Sex Steroids

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7
Q

Name a Mineralocorticoids

A

Aldosterone

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8
Q

Name a glucocorticoid

A

Cortisol

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9
Q

What part of the cortex secrete glucocorticoids

A

Zona Fasciculata

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10
Q

What part of the cortex secrete minerlocorticoids

A

Zona glomerulosa

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11
Q

What part of the cortex secrete sex hormones

A

Zona Reticularis

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12
Q

Where is aldosterone synthase found

A

Zona glomerulosa

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13
Q

Where is 21 Hydroxylase found

A

Both glomerulosa and fasciculata

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14
Q

What does a defect in 21 Hydroxylase case

A

Defects in 21-hydroxylase is a common cause of congenital adrenal hyperplasia resulting in deficiency of aldosterone and cortisol and associated disruption of salt and glucose balance.

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15
Q

What are symptoms of a fetal Defect in 21-hydroxylase and why

A

Babies are born with malformed genitalia and if untreated it can be fatal.

Because, Androgen biosynthesis is unaffected so accumulating steroid precursors are channelled into excessive adrenal androgen production.

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16
Q

What are the levels of ACTH and CRH like in a 21 hydroxylase deficiency

A

HIGH (as lose inhibition)

17
Q

What is cortisols function

A

Cortisol as a glucocorticoid is crucial in helping to protect the brain from hypoglycaemia. It has a permissive action on glucagon, which is vitals as glucagon alone is inadequate in responding to a hypoglycaemic challenge

18
Q

How does cortisol travel in the blood

A

~95% of plasma cortisol is bound to a carrier protein, cortisol binding globulin (CBG)

19
Q

When are cortisol levels highest

A

6am-9am

20
Q

When are cortisol levels lowest

A

midnight

21
Q

Does the ACTH or Cortisol last longer in the blood

A

Cortisol “burst” persists longer than ACTH burst because half-life is much longer.

22
Q

What are the glucocorticoid actions of cortisol

A

Gluconeogenesis
Lipolysis
Proteolysis
Decreased Insulin Sensitivity

23
Q

How does cortisol increase gluconeogenesis

A
  • Cortisol stimulates formation of gluconeogenic enzymes in the liver thus enhancing gluconeogenesis and glucose production. This is aided by cortisol’s action on muscle (proteolysis)
24
Q

How does cortisol increase Proteolysis

A
  • cortisol stimulates the breakdown of muscle protein to provide gluconeogenic substrates for the liver.
25
Q

How does cortisol increase lipolysis

A
  • cortisol stimulates lipolysis in adipose tissue which increases [FFA] plasma creating an alternative fuel supply that allows [BG] to be protected (not used by muscles) while also creating a substrate (glycerol) for gluconeogenesis.
26
Q

What are the non-glucocorticoid actions of cortisol

A

Negative effect on Ca2+ balance

Impairment of mood and cognition

Permissive effects on norepinephrine

Suppression of the Immune System

27
Q

How does cortisol affect Calcium balance

A

Decrease absorption from gut, increases excretion at kidney resulting in net Ca2+ loss. Also increase bone resorption

28
Q

What is the result of the

Permissive effects on norepinephrine of cortisol

A

vasoconstriction - particularly in vascular smooth muscle

29
Q

How does cortisol suppress the immune system

A

Cortisol reduces the circulating lymphocyte count, reduces antibody formation and inhibits the inflammatory response. Latter effect can be useful clinically e.g. asthma/ulcerative colitis/organ transplant

Endocrine (14 decks)

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