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Pathophysiology > Endocrinology: Adrenal Glands > Flashcards

Endocrinology: Adrenal Glands Flashcards

1
Q

zona glomerulosa makes what hormone

A

mineralcorticoids
**aldosterone
constitues about 15% of cortex

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2
Q

zona fasciculata makes what hormone

A

glucocoticoids
*cortisol
constitues about 78% of cortex

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3
Q

Zona Reticularis makes what hormone

A

*estrogens/Androgens—DHEA and androstenedione

constitues about 7% of cortex

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4
Q

what does Chromaffin cells produce

A

catecholamines

*epi and norepi

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5
Q

where are the catecholamines produced

A

medulla

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6
Q

effects of glucocorticoids

A
  • anti-inflammatory
  • metabolic–CHO
  • neurologic
  • growth suppressing
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7
Q

glucocorticoids stimulate what in liver ?

A

gluconeogenesis in liver

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8
Q

how does glucocortiods promote gluconeogenesis

A

via decreasing uptake of glucose into muscle cells, adipose cells and lymphatic cells

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9
Q

glucocorticoids effect on immunity?

A

innate and adaptive immunity
AKA some SE when tx with glucocorticoids:
*poor wound infection
*incr risk of infections

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10
Q

GLucocorticoids effect on proteins?

A
  • stimulate catabolism

* **breakdown protein in the body

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11
Q

glucorticoids effect on AAs?

A

inhibit amino acid uptake and protein

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12
Q

glucocorticoids effect on bone?

A

inhibit bone formation

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13
Q

glucocorticoids effect on ADH secrtion

A

inhibit it

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14
Q

Glucocorticoids effect on gastric acids?

A

stimulate gastric acid secretion

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15
Q

most superficial layer of adrenal cortex?

A

Zona Glomerulosa

*just under the capsule

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16
Q

what enzyme does the zona glomerulosa cells have

A

aldosterone synthase

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17
Q

secretion of aldosterone is controllled by?

A

ECF [ ] of angiotensin II and K+

1. RAAS system

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18
Q

mineralcorticoid action

A

regrulates ECF fluid volume

  • stimulates reabsoprtion of NA in kidneys AKA Na+ retention**
  • stimulates secretion of K+ and H+ in kidneys
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19
Q

how does aldosterone cause NA retention?

A

by increasing the acts of the sodium pumps in nephrons

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20
Q

what stimulates RAAS? (3)

A
  1. Hyperkalemia
  2. hyponatremia and water depletion
  3. hypotension or decr blood volume–sepsis, hemm
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21
Q

middle layer of the adrenal cortex

A

zona fasiculata

*secretes cortisol

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22
Q

release of ACTH stim by? (4)

which is inhibitory and which is stimulatory

A
  1. CRH–stimulatory
  2. free cortisol–inhibitory
  3. stress–stimulatory
  4. sleep-wake cycle–circadian rhythm
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23
Q

deepest layer of adrenal cortex

A

zona Reticularis

*adrenal adrogens

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24
Q

sexual characterisitcs are determiend by?

A

gonadal testosterone

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25
Q

what supresses androgens

A

exogenous glucocorticoids

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26
Q

cells found in the adrenal medulla?

A

Chromaffin cells—pheochromocytes

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27
Q

function of chromaffin cells

A

storage of catecholamines–epi and norepi

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28
Q

epi and norepi synthesizes from which AA?

A

AA–phenylalanin

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29
Q

only ___% of the circulating epi is secreted from adrenal medulla

-where does the rest come from?

A

30%

*rest comes from nerve terminals in sympNS–secreted when body need it

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30
Q

when do chromaffin cells release catecholamines

A
  • stress
  • trauma
  • physiological stress: hypoclygemia, hypoxia, hypovolemia,
31
Q

which hormones of the adrenal cortex are protein bound

A

cortisol

androgens

32
Q

ACTH produced in?

A

AP

33
Q

which hormone stimulates ACTH

A

Cortiotropin rel hormone in hypothalm

34
Q

which part of adrenal gland has high vasculature

A

adrenal medulla–so catecholamines get into blood right away

35
Q

which nerve innervates adrenal gland

A

splanchnic nerve

36
Q

which cells in kidneys stimulate renin

A

juxtaglomerular cells

37
Q

what there is decreased perfusion…. what happens (in kidneys(

A

JG cells stimulate kidneys to stimulate renin

38
Q

function of renin

A

renin converts angiotensinogen–>angiotensin I—>converted to angiotensin II via ACE

39
Q

where is angiotensinogen found

A

liver

40
Q

where is ACE found

A

lung capillaries

41
Q

angiotensin II is a potent?

A

vasocontrictor—incrs BP

42
Q

Angiotensin II stimulates____

A

Aldosterone from adrenal cortex

43
Q

aldosterones action on kidney tubules

A
  1. increases reabsoprtion of NA
  2. increases excretion of K+ and H+ via tubules
  3. incrs water retention–incrs blood volume–incrs BP
  4. prevents acidosis via secretion of H+
44
Q

ADH comes frOM? and is responsible for?
vs
Aldosterone comes from? and resp for?

which is a secondary and primary cause of fluid overload?

A

ADH—-post pit…resp for reabsorption of h20–causing water retention

aldosterone— adrenal cortex— resp for h20 and NA reabsoprtion— causing water retention–

***fluid overload
ADH=secondary cause
Aldosterone=primary cause

45
Q

angiotensin II stimulates release of ___ (2)

A

ADH or vasopresin
&
Aldosterone

46
Q

who is in charge of long term BP regulation

A

aldosterone

ADH/vasopressin

47
Q

what is a main SE of longterm use of exogenous glucocorticoids?

A

osteoporosis—bc glucocorticoids inhibit bone formation

48
Q

WBC count rises/lowers when on glucocortioids

WHY???

A

INCREASES

*glucos inhbit bone formation–osteoporosis–bone b/d releases immune cells— increases LEUKOCYTES

49
Q

less of cortisol are HIGH/LOW in am?

A

high

50
Q

explain anti-inflammatpry funct of cortisol

A

inhibits WBC leukocytes–decreases the immune responses and can delay healing of damaged tissue

51
Q

the release of cortisol is____?

A

pulsatile
AND
circadian

52
Q

what does pulsatile relese of cortisol mean

A

its rel in spurts— >7 times throughout the day

53
Q

which receptor in the adrenal gland does ACTH bind to

A

melanocortin-2 receptor

54
Q

where is aldosterone metabolized and excreted

A

liver

urine

55
Q

what controls release of androgens

A

ACTH

56
Q

which is the most abundant circulating hormone in the body?

A

DHEA

57
Q

major function of testosterone

A

masculinization and libido

58
Q

in women, androgens are converted to?

A

estrogen and progesterone

59
Q

in post menopausal women, where is the main supply of endogenous estrogen?

A

adrenal cortex

60
Q

low levels of DHEA are assoc with what diseases in mn and women

A

cardiovasc in men

premenopausal BC and OC in women

61
Q

high levels of DHEA can put a women at risk for?

A

postmenopasual BC

62
Q

what is increased aldosterone secretion called

decreaad?

A

hyPERaldosternonism

HYPOaldosteronism

63
Q

Increasd cortisol secretion leads to?

A

Cushing’s syndrome

64
Q

what is decreased cortisol secretion called

A

adrenal insufficiency

65
Q

Conn syndrome can cause?

A

hypernatremia
hyPOkalemia
HTN

66
Q

MCC of primary hyperaldosteronism?

A

bilateral adrenal hyperplasia

67
Q

conn sydrome is a type of?

A

primary hyperaldosteronism

68
Q

MCC of secondary hyperaldosteronism?

A

renal artery stenosis

69
Q

primary hyperaldosteronism is a cause of ____

A

secondary HTN

70
Q

what do we suspect in PTs <30 or >60 who develop sudden HTN

A

primary hyperaldosteronism

71
Q

what do we suspect with PTs who have uncontrolled HTN after trying 3 different BP meds?

A

primary hyperaldosteronism

72
Q

addison’s disease is?

MCC?

A

when over 90% of adrenal tissue is destroyed

*MC cause–> autoimmune destruction

73
Q

primary hypoaldosteronism MC caused by?

A

addison’s disease–>adrenal insufficiency

Pathophysiology (13 decks)

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