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Pathoma LAH > Endocrine: 15.10: Adrenal Cortex > Flashcards

Endocrine: 15.10: Adrenal Cortex Flashcards

1
Q

What is Cushing syndrome?

A

excess cortisol

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2
Q

Pregnenolone is converted into _____ via 21-hydroxylase AND 11-hydroxylase.

A

cortisol

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3
Q

What is made in the zona reticularis?

A

sex steroids

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4
Q

What are the s/s of chronic adrenal insufficiency?

A
  • lack of cortisol:
    • hypotension
    • increased ACTH –> hyperpigmentation (esp of oral mucosa)
    • vomiting, diarrhea
  • lack of aldosterone:
    • hyponatremia
    • hypovolemia
    • hyperkalemia
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5
Q

The adrenal cortex secretes hormones derived from _____.

A

cholesterol

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6
Q

Why do pts with Cushings get HTN?

A

cortisol upregulates alpha-1 receptors on arterioles –> increased effects of NE

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7
Q

Pregnenolone is converted into cortisol via _____.

A
  • 21-hydroxylase AND
  • 11-hydroxylase
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8
Q

Pregnenolone is converted into ______ via 21-hydroxylase.

A

mineralocorticoids and cortisol

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9
Q

How does cortisol cause immunosuppression?

A
  • inhibits phospholipase A2
  • inhibits IL-2
  • inhibits mast cell histamine release
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10
Q

What happens in Waterhouse-Friderichsen syndrome?

A

DIC –> bilateral necrosis of adrenal glands –> acute lack of cortisol –> massive hypotension

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11
Q

What is made in the zona fasciculata?

A

cortisol (glucocorticoids)

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12
Q

ACTH is derived from _____.

A

POMC

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13
Q

Name a mineralocorticoid.

A

Aldosterone

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14
Q

Cortisol ____ blood sugar by breaking down muscle.

A

increases

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15
Q

What are the lab findings in hyperaldosteronism?

A
  • hypernatremia
  • hypokalemia
  • metabolic alkalosis
  • HTN
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16
Q

Aldosterone causes ____ Na+ and _____ K+.

A
  • increased Na+
  • decreased K+
17
Q

Pregnenolone is converted into cortisol via _____.

A

21-hydroxylase

18
Q

How is Cushings diagnosed?

A
  • increased 24 hour urinary cortisol
  • high dose dexamethasone test
19
Q

What happens if phospholipase A2 is inhibited?

A

no arachidonic acid metabolites form –> no inflammation

20
Q

What is 17-hydroxylase important for?

A

pregnenolone conversion into cortisol and sex steroid hormones

21
Q

Acute adrenal insuffienciency is usually caused by ______.

A

Waterhouse-Friderichsen syndrome

22
Q

Why is cortisol essential for life?

A

it regulates blood vessel tone

23
Q

In which hydroxylase deficiency is cortisol not produced?

A

ALL of them! (17, 11, 21)

24
Q

What will the results of a high dose dexamethasone test be in Cushings from a pituitary adenoma?

A

suppression

25
Q

What cancer loves to metastasize to the adrenals?

A

lung cancer

26
Q

What will the results of a high dose dexamethasone test be in Cushings from an ectopic ACTH producing cancer?

A

failure of suppression

27
Q

Why are abdominal striae seen in Cushings?

A

cortisol impairs collagen synthesis –> BVs rupture easily

28
Q

What are the s/s of 21-hydroxylase deficiency in a female?

A
  • clitoral enlargement
  • hypotension
  • bilateral adrenal hyperplasia
  • hyponatremia
  • hyperkalemia
  • dehydration
29
Q

Dx?

  • adrenal gland looks like a sack of blood
A

Waterhouse-Friderichsen syndrome

30
Q

Excess insulin causes _____ storage of fat.

A

increased

31
Q

What bacteria causes Waterhouse-Friderichsen syndrome?

A

N. meningiditis

32
Q

What happens when IL-2 is inhibited?

A

T-cells aren’t stimulated to grow

33
Q

What are the s/s of 21-hydroxylase deficiency in a male?

A
  • precocious puberty
  • hypotension
  • bilateral adrenal
  • hyperplasia
  • hyponatremia
  • hyperkalemia
  • dehydration
34
Q

Name the 2 catecholamines.

A
  1. Epi
  2. NE
35
Q

Pregnenolone is converted into mineralocorticoids via _____.

A

21-hydroxylase

36
Q

Name the most common tumor to secrete ACTH.

A

small cell carcinoma of the lung

37
Q

If there is a deficiency of 21-hydroxylase, there will be decreased _____ and increased _____.

A
  • decreased mineralocorticoids and cortisol
  • increased sex steroid hormones

Pathoma LAH (77 decks)

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