Endocrine: Adrenal Cortex (Cortisol)

Question 1

Affects blood pressure, glucose abnormalities
NEO, LY, GLY

Answer 1

Cortisol

Question 2

Main glucocorticoids
Most abundant adrenal hormone

Answer 2

Cortisol

Question 3

Second most abundant adrenal hormone

Answer 3

DHEA

Question 4

1. Cortisol is stimulated by adrenocorticotropic hormone
2. Diurnal Pattern
3. Stress

Answer 4

Factors Affecting Cortisol Secretion

Question 5

Urinary Metabolite:

Method: Porter Silber Method (Yellow)
Reagent: Phenylhydrazine in H2SO4 + Alcohol

Answer 5

17-Hydroxycorticosteroids

Question 6

Urinary Metabolite:

Method: Zimmerman (Red-purple)
Reagent: Meta-Dinitrobenzene

Answer 6

17-ketogenic steroids

Question 7

Excessive production of CRH, ACTH, Glucocorticoids, Androgens

Answer 7

Hypercortisolism

Question 8

Dexamethasone
Metyrapone

Answer 8

Supressant of Cortisol

Question 9

Increased serum cortisol
Decreased ACTH

Answer 9

Crushing Syndrome (Adrenal)

Question 10

Increased serum cortisol
Increased ACTH

Answer 10

Crushing disease (Pituitary)

Question 11

High ACTH
ACTH Dependent

Answer 11

Primary ACTH (pituitary)
Ectopic ACTH
Ectopic CRF

Question 12

Low ACTH
ACTH independent

Answer 12

Adrenal adenoma
Adrenal carcinoma
Modular Adrenal Hyperplasia
Exogenous Glucocorticoids

Question 13

Suppressant of Cortisol:

substitute of Cortisol ; suppressing ACTH

Answer 13

Dexamethasone

Question 14

Suppressant of Cortisol:

Blocks cortisol synthesis; block 11B- Hydroxylase = Inc. ACTH

Answer 14

Metyrapone

Question 15

Increased serum cortisol
Decreased ACTH
Hyperglycemia

Answer 15

Cushing Syndrome

Question 16

Excessive production of ACTH due to pituitary hormone

Answer 16

Secondary Hypercortisolism

Question 17

Hypercortisolism:

24 hr urinary Free Cortisol Test
Overnight Dexamethasone Supression Test
Midnight Salivary Cortisol Test

Answer 17

Screening Test (Hypercortisolism)

Question 18

Hypercortisolism:

Low-dose dexamethasone Test
Midnight PLASMA Cortisol Test
CRH stimulation Test

Answer 18

Confirmatory Test (Hypercortisolism)

Question 19

Supresses pituitary secretion of ACTH
Decreased ACTH stimulatio

Answer 19

Dexamethasone Suppression Test

Question 20

Provocative Testing
25X more potent than cortisol

Answer 20

Overnight/Rapid Dexamethasone Suppression Test

Question 21

Differentiate Healthy Individual from patient with Crushing Syndrome

Answer 21

Low-Dose Dexamethasone Suppression Test
(+) Elevated Cortisol

Question 22

Differentiate patients with bilateral adrenal HYPERPLASIA FROM HYPERCORTISOLISM

Answer 22

High-Dose Dexamethasone
2mg every 6hrs