cortisol

Question 1

cortisol released by

Answer 1

adernal glands

Question 2

cortisol hormone

Answer 2

steroid, stress
potent glucocorticoid hormone – help increase glucose

Question 3

cortisol measured

Answer 3

serum
urine

Question 4

cortisol regulates what metabolic processes

Answer 4

○ Blood pressure
○ Sodium increase/decreases
○ Gluconeogenesis
○ Cardiac function
○ Protein metabolism

Question 5

cortisol regulated

Answer 5

negative feedback loop
-gets to certain amount will shut off other components

Question 6

cortisol starts

Answer 6

hypothalamus – releases CRH ( corticotrophin releasing hormone)

Question 7

CRH kick starts the

Answer 7

pituitary gland

pituitary releases ACTH (adrenocorticotropic hormone)

Question 8

ACTH kick starts

Answer 8

adrenal gland to release cortisol

Question 9

When cortisol reaches high enough levels

Answer 9

it gets inhibits ????

Question 10

90% of cortisol bound to

Answer 10

cortisol binding globulin

Question 11

When cortisol is in excess

Answer 11

easily excreted by the kidney

Question 12

cortisol involved in muscle breakdown

Answer 12

helps release amino acids that may be needed

Question 13

Amino acids will help to increase glucose levels

Answer 13

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Question 14

When body needs to gluconeogenesis, release of

Answer 14

fatty acids will greatly increase levels of sugar for short period of time

part of fight or flight

Question 15

cortisol has ability to increase

Answer 15

○ Gluconeogenesis
○ Glycogen synthesis
○ Lipolysis
○ Blood sugar
○ Protein catabolism

Question 16

cortisol effect blood pressure

Answer 16

increase GFR- amount of blood filtered through glomerulus

Question 17

cortisol will increase, decrease

Answer 17

ADH– will lose more water than sodium

increase BP, and move sodium out of cell if needed

Question 18

ACTH and cortisol are

Answer 18

diurnal analytes

cortisol most diurnal analyte that we measure (need to measure 2 times a day)

highest in the morning - 8am
lowest- 4 pm

Question 19

cushing syndrome

Answer 19

excessive cortisol

Question 20

hypercortisolism

Answer 20

Can be exogenous or endogenous driven

Question 21

exogenous

Answer 21

due to administration of cortisol (helps decrease inflammation)– autoimmune disease

-can increase levels
-trigger hypothalamus to stop releasing and so on
-need to slowly step down, NO COLD TURKEY

Question 22

endogenous

Answer 22

adernal tumor
cushing disease
tumor of non endocrine tissue

Question 23

adernal tumor

Answer 23

increase cortisol

ACTH– decrease

Question 24

cushing disease

Answer 24

pituitary tumor - most common reason for endogenous disease

ACTH increase and cortisol increased

Question 25

in adernal tumor and cushing disease in both cases

Answer 25

diurnal variation of ACTH and cortisol will be affected

Question 26

tumor on non endocrine tissue

Answer 26

lung -- increase ACTH and cortisol

Question 27

cushing disease

Answer 27

pear shaped and skinny legs red and round face-- moon face, puffy and no neck severe fatigue/ muscle wasting -- because cortisol increase muscle breakdown often become diabetic -- increased gluconeogenesis

Question 28

in cushing disease increase in (analyte)

Answer 28

sodium at expense of K may lead to metabolic alkalosis -- lose of hydrogen ions

Question 29

testing for cushing

Answer 29

start with both cortisol and ACTH -look for diurnal variation if variation = endogenous type of issue

Question 30

urinary measurements excess cortisol excreted in the

Answer 30

kidney

Question 31

measure 17 hydroxy corticosteriod

Answer 31

byproduct of cortisol -eliminated in urine

Question 32

if measuring urine do

Answer 32

24 hr urine

Question 33

dexamethasone supression test

Answer 33

given to suppress cortisol levels in normal person-- will suppress levels in cushing syndrome person-- no suppressing

Question 34

addison's disease

Answer 34

hypocortisolism destruction of adrenal gland -- caused by autoimmune reaction against adrenal gland -also by TB, histoplasmosis,etc.

Question 35

in addison's disease decrease

Answer 35

cortisol levels, increase ACTH

Question 36

symptoms of addison's disease

Answer 36

○ Weight loss ○ Bad reaction to stress -- no cortisol ○ Decrease glucose-- no lipid breakdown ○ Decrease Na ○ Renal shutdown ○ Vascular collapse -- decrease BP

Question 37

where is adrenal gland found

Answer 37

above the kidney

Question 38

2 layers of adrenal gland

Answer 38

medulla (inner) cortex (outer)

Question 39

adernal medulla produce

Answer 39

catecholamines; from tyrosine ex. dopamine norepinephrine epinephrine

Question 40

responsible for mobilizing energy storage

Answer 40

norepinephrine epinephrine -increase blood sugar, BP,

Question 41

as Epinephrine and Norepinephrine break down they produce

Answer 41

metanephrines and vanillylmandelic acid -the only time we care is when produce excess

Question 42

Excess production of catecholamines is when there is a tumor of the adrenal medulla

Answer 42

pheochromocytomas (tumor of adrenal medulla)

Question 43

Think of tumor as gas pedal -- tumor = excess of

Answer 43

catecholamines (mainly 2 epinephrine)

Question 44

increase of catecholamines can lead to

Answer 44

increased heart rate-- lead to heart attack increase blood sugar without being diabetic chronic hypertension -if caught early enough curable -a lot go undiagnosed and become malignant

Question 45

how to diagnosis pheochromocytomas

Answer 45

looking at metabolites-- Urinary metanephrines and VMA; will be found in high amounts

Question 46

specimen for diagnosis pheochromocytomas

Answer 46

24 hour urine -- bypass diurnal variation preferred to measure metanephrines

Question 47

neuroblastomas

Answer 47

○ Malignant tumors of adrenal medulla typically seen in children arise along sympathetic nervous system excess catecholamines

Question 48

adrenal cortex secretion most sig

Answer 48

mineral corticoids of which aldosterone

Question 49

aldosterone

Answer 49

most important vasoconstrictor in the body -production starts when renin released by kidney

Question 50

renin produced when

Answer 50

sodium levels low

Question 51

what acts on angiotensin converting to angiotensin 1

Answer 51

renin

Question 52

what converts angiotensin 1 to angiotensin 2

Answer 52

ACE

Question 53

what kicks adrenal cortex to produce aldosterone

Answer 53

angiotensin 2

Question 54

main function of aldosterone

Answer 54

retaining sodium at expense of potassium -DIURNAL VARIANT

Question 55

classified as primary or secondary hypoaldosteronism

Answer 55

hyperaldosteronism

Question 56

primary hyperaldosteronism caused by

Answer 56

tumor of the adrenal cortex CALLED CONN syndrome

Question 57

more aldosterone=

Answer 57

more sodium -follow each other

Question 58

hyperaldosteronism can result in

Answer 58

metabolic alkalosis -low serum K-- to balance-- K comes out of cells-- + comes out + must go in=== hydrogen less hydrogen= alkalosis

Question 59

how to diagnosis primary hyperaldosteronism

Answer 59

manipulate sodium intake

Question 60

If a lot of sodium in blood stream-

Answer 60

aldosterone will decrease

Question 61

If you give sodium will

Answer 61

not affect aldosterone ?? In Conn's syndrome

Question 62

If restrict sodium intake --

Answer 62

aldosterone should increase (not a lot of sodium so want to keep)

Question 63

Secondary Hyperaldosteronism

Answer 63

* Excess production of renin * Can have tumor secret renin or narrowing of renal artery

Question 64

hypoaldosteronism caused by

Answer 64

Addison's disease -- destruction of adrenal gland -decreased serum Na -mild increase K

Question 65

why mild hypoglycemia in hypoaldosteronism

Answer 65

adrenal gland destroyed which produces cortisol which helps with glucose