Cortisol

Question 1

3 layers to the adrenal cortex

Answer 1

outer: zona glomerulosa
middle: zona fasciculata
inner: zona retiularis

Question 2

Glucocorticoids are produced where in the adrenal cortex

Answer 2

zona fasciculata

Question 3

Glucocorticoids

Answer 3

CORTISOL- essential to life for protein and carbohydrate metabolism

Question 4

Mineralcorticoids are produced where in the adrenal cortex

Answer 4

zona glomerulosa

Question 5

Mineralcorticoids

Answer 5

Aldosterone

Question 6

Precursore to corticoids?

Answer 6

Cholesterol; can be stored in endocrine cells as ester

Question 7

StAR

Answer 7

transports cholesterol into mito

Question 8

P450 (Rate-limiting)

Answer 8

hydroxylates cholesterol into pregnenolone

Question 9

Rate of steroid hormone secretion can only be controlled by

Answer 9

hormone synthesis (steroids cannot by stored)

Question 10

Cortisol binds __________ in blood

Answer 10

transport protein CORTICOSTEROID-BINDING GLOBULIN (CBG) or TRANSCORTIN

Question 11

Estrogen effect on transcortin

Answer 11

increases its synthesis

Question 12

Cortisol effect?

Answer 12

increased gluconeogenesis, protein degradation for aa substrates for gluconeogenesis, increased glucagon, decreased GLUT4

Question 13

a fasting person without cortisol

Answer 13

CANNOT MOBILIZE PROTEINS

Question 14

Cortisol is permissive for

Answer 14

EPI and GH lipolysis “glucose-sparing effect”

NE, EPI, ADH, and GH

Question 15

Cortisol causes

Answer 15

lipolysis in some adipose tissues, while in trunk and neck causes lipogenesis (moon face and abdominal fat)

Question 16

Cushing’s disease

Answer 16

chronic exposure to high levels of cortisol (moon face and abdominal fat)

Question 17

Cardiovascular permissive effect of cortisol

Answer 17

cortisol is permissive to catecholamines and angiotensin for contraction of vascular smooth muscle and contraction to maintain MAP

Question 18

Permissive cardiovascular effects of cortisol re due to

Answer 18

increased beta receptors and increased Ca channels

Question 19

Cortisol is permissive for growth with

Answer 19

GH and EPI

Question 20

Steroid/cortisol have ______________ properties and are used for treatment

Answer 20

anti-inflammatory and anti-immune effects (inhibit inflammation and leukotriene and prostaglandin synthesis)

Question 21

Side effects of using cortisol treatment

Answer 21

causes general breakdown of proteins, thinning of skin, muscle wasting, bone breakdown, ACTH secretion is suppressed (must ease off treatment)

Question 22

Metabolism of cortisol

Answer 22

slow, in liver

Question 23

Release of Cortisol

Answer 23

Stress/trauma –> CRH (hypothalamus) –> ACTH (anterior pituitary) –> Cortisol (adrenal cortex)

Question 24

Mechanism for ACTH to increase cortisol

Answer 24

LDL uptake, hydrolysis of cholesterol, transport StAR into mito, binding of P450 to cholesterol

Question 25

ACTH chronic

Answer 25

hypertrophy of adrenal cortex

Question 26

Negative feedback loop

Answer 26

cortisol inhibits anterior pituitary and hypothalamus

Question 27

Diurnal pattern of ACTH-cortisol

Answer 27

greatest in the morning, lowest at night (highest when fasting)

Question 28

Cortisol spikes are proportional to

Answer 28

the magnitude of the trauma (despite (-)feedback loop)

Question 29

Addison's Disease

Answer 29

diminished cortisol, despite high levels of CRH and ACTH

Question 30

Pituitary adenoma

Answer 30

high ACTH and Cortisol, low CRH

Question 31

Adrenal adenoma (cushings disease)

Answer 31

high cortisol, low CRH and ACTH

Question 32

Ectopic production of ACTH (cushing's syndrome)

Answer 32

ACTH high in plasma, low production in pituitary, high cortisol, low CRH

Question 33

Iatrogenic Cushings SYNDROME

Answer 33

High cortisol from medication, low CRH, low ACTH, and low Cortisol from adrenal cortex

Question 34

removal of cortisol treatment of resection of cortisol secreting tumor

Answer 34

must be done slowly to allow ACTH and adrenal cortex to gradually become functional again

Question 35

Dexamethasone suppression test at low doses

Answer 35

normal ppl should have suppressed ACTH, cushings syndrome no suppression

Question 36

Dexamethasone suppression test at high doses

Answer 36

Cushing's disease of pituitary gland is suppressed but Cushing's syndrome of ectopic location is NOT suppressed