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Endocrine > Cortisol > Flashcards

Cortisol Flashcards

1
Q

3 layers to the adrenal cortex

A

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

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2
Q

Glucocorticoids are produced where in the adrenal cortex

A

zona fasciculata

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3
Q

Glucocorticoids

A

CORTISOL- essential to life for protein and carbohydrate metabolism

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4
Q

Mineralcorticoids are produced where in the adrenal cortex

A

zona glomerulosa

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5
Q

Mineralcorticoids

A

Aldosterone

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6
Q

Precursore to corticoids?

A

Cholesterol; can be stored in endocrine cells as ester

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7
Q

StAR

A

transports cholesterol into mito

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8
Q

P450 (Rate-limiting)

A

hydroxylates cholesterol into pregnenolone

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9
Q

Rate of steroid hormone secretion can only be controlled by

A

hormone synthesis (steroids cannot by stored)

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10
Q

Cortisol binds __________ in blood

A

transport protein CORTICOSTEROID-BINDING GLOBULIN (CBG) or TRANSCORTIN

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11
Q

Estrogen effect on transcortin

A

increases its synthesis

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12
Q

Cortisol effect?

A

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

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13
Q

a fasting person without cortisol

A

CANNOT MOBILIZE PROTEINS

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14
Q

Cortisol is permissive for

A

EPI and GH lipolysis “glucose-sparing effect”

NE, EPI, ADH, and GH

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15
Q

Cortisol causes

A

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

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16
Q

Cushing’s disease

A

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

17
Q

Cardiovascular permissive effect of cortisol

A

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

18
Q

Permissive cardiovascular effects of cortisol re due to

A

increased beta receptors and increased Ca channels

19
Q

Cortisol is permissive for growth with

A

GH and EPI

20
Q

Steroid/cortisol have ______________ properties and are used for treatment

A

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

21
Q

Side effects of using cortisol treatment

A

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

22
Q

Metabolism of cortisol

A

slow, in liver

23
Q

Release of Cortisol

A

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

24
Q

Mechanism for ACTH to increase cortisol

A

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

25
Q

ACTH chronic

A

hypertrophy of adrenal cortex

26
Q

Negative feedback loop

A

cortisol inhibits anterior pituitary and hypothalamus

27
Q

Diurnal pattern of ACTH-cortisol

A

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

28
Q

Cortisol spikes are proportional to

A

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

29
Q

Addison’s Disease

A

diminished cortisol, despite high levels of CRH and ACTH

30
Q

Pituitary adenoma

A

high ACTH and Cortisol, low CRH

31
Q

Adrenal adenoma (cushings disease)

A

high cortisol, low CRH and ACTH

32
Q

Ectopic production of ACTH (cushing’s syndrome)

A

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

33
Q

Iatrogenic Cushings SYNDROME

A

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

34
Q

removal of cortisol treatment of resection of cortisol secreting tumor

A

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

35
Q

Dexamethasone suppression test at low doses

A

normal ppl should have suppressed ACTH, cushings syndrome no suppression

36
Q

Dexamethasone suppression test at high doses

A

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

Endocrine (9 decks)

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