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Endocrinology > Exam 1: Adrenals > Flashcards

Exam 1: Adrenals Flashcards

1
Q

2 hormones of the adrenals

A

Outer cortex: steroids

Inner medulla: catacholamines

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2
Q

Without adrenal hormones

A
  • deranged electrolyte levels cause circulatory collapse

- impaired carbohydrate metabolism (hypoglycemic coma) causes death

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3
Q

Medulla (ectoderm) secretes

A

Epinephrine and norepinephrine

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4
Q

Cortex (mesoderm) secretes

A

Steroid hormones: glucocorticoids, mineralcorticoids, androgens

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5
Q

Mineralcorticoids

A

Control of Na and K

Secretion controlled by renin-angiotensin System

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6
Q

Glucocorticoids

A

Affect body fuel metabolism

Secretion controlled by ACTH

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7
Q

Androgens

A

Similar function to testes

Secretion controlled by ACTH

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8
Q

Sustained stimulation of adrenal glands can ________ output

A

Increase

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9
Q

Fast acting medullary hormones signal

A

Physiologic adjustments

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10
Q

Slow acting cortical hormones maintain or increase

A
  1. Sensitivity to medullary hormones
  2. Capacity of tissue to respond to medullary hormones

Act as modulators

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11
Q

Precursor for adrenocorticcaal steroids

A

Cholesterol

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12
Q

____ are essential for life

A

Glucocorticoids

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13
Q

2 glucocorticoids

A

Cortisol and corticosterone

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14
Q

Drugs that inhibit glucocorticoids

A

Metyrapone and ketoconazole

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15
Q

Metyrapone

A

Used in diagnosis of adrenal insufficiency and cushings

Inhibits 11-Beta hydroxylase

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16
Q

Ketoconazole

A

Treats fungal infections

Inhibits cholesterol desmolase

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17
Q

Physiologic functions of glucocorticoids

A
  1. Increase gluconeogenesis and storage of glycogen
  2. Anti-inflammatory
  3. Suppresses immune response (thymus)
  4. Maintains vascular responsiveness (catecholamines)
  5. Inhibit bone formation
  6. Increase GFR
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18
Q

Cortisol affects _____, ______, and ____ metabolism to increase glucose synthesis

A

Protein, fat, and CHO

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19
Q

Cortisol decreases

A
  1. Utilization of glucose by tissues

2. Adipose insulin sensitivity

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20
Q

_______are essential for survival during fasting

A

Glucocorticoids

They increase gluconeogenesis

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21
Q

Actions of cortisol that inference with inflammatory response

A
  1. Induces synthesis of lipocortin
  2. Inhibits production of interleukin-2 and proliferation of T lymphocytes
  3. Inhibits release of histamine and serotonin from mast cells and platelets
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22
Q

Glucocorticoids prevent hypoglycemia by

A

Decreasing utilization of glucose by muscles and adipose

Decreasing responsiveness of tissues to insulin

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23
Q

Prolonged exposure to high glucocorticoids leads to

A

Diabetes mellitus

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24
Q

Increase in use of glucose and increase of gluconeogenesis

A

Increase in glycogen storage in liver and muscle

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25
Q

Maintaining vascular responsiveness to catacholamines

A

Maintains normal blood pressure

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26
Q

Less cortisol=______

More cortisol=_______

A

Hypotension

Hypertension

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27
Q

Inhibition of bone formation

A
  1. Decrease osteoblastic formation

2. Decrease intestinal calcium absorption so the synthesis of type 1 collagen decreases

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28
Q

Increase in GFR

A

Causes vasodilation of afferent arterioles and increase in renal blood flow

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29
Q

Glucocorticoids effects on CNS

A
  1. Decrease REM sleep
  2. Increase slow wave sleep
  3. Increase awake time
  4. Large bursts of ACTH and cortisol just before waking up
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30
Q

Glucocorticoids effect on lung development in fetus

A

Maturation of alveoli and produces surfactant

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31
Q

Cortisol secretion is ____ and _____

A

Pulsatile and diurnal

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32
Q

Lowest secretory rates of cortisol occur

A

In the evening and after falling asleep

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33
Q

Highest secretory rates of cortisol occur

A

Before waking and in the morning

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34
Q

What converts cortisol to cortisone

A

11 beta hydroxysteroid

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35
Q

Cortisol is ____ and cortisone is _____

A

Active and inactive

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36
Q

Sesame that’s one suppression test

A

Determines cause of hypercortisolism (tumor of anterior pituitary or adrenal)

37
Q

Inhibited of ACTH secretion

A
  1. Increase blood cortisol levels
  2. Opioids
  3. Somatostatin
38
Q

Stimulators of ACTH secretion

A
  1. Decrease blood cortisol levels
  2. Sleep-wake transition
  3. Stress
  4. Surgery
  5. Trauma
  6. Hypoglycemia
  7. Psychiatric disturbances
  8. ADH
  9. Alpha and beta adernergic agonists
  10. Serotonin
39
Q

Major mineralcorticoids

A

Aldosterone

40
Q

Synthesized in zona glomerulosa

A

Aldosterone

41
Q

Other hormones with mineralcorticoids activity

A

11-deoxycorticosterone and corticosterone

42
Q

Regulation of aldosterone

A

Renin-angiotensin-aldosterone system

43
Q

ACTH has a tonic secondary effect on _______ secretion

A

Aldosterone

44
Q

Excess aldosterone

A
  1. Increase sodium reabsorption
  2. Increase potassium and hydrogen excretion
  3. Increase ECF volume
  4. Hypertension
  5. Hypokalemia
  6. Metabolic alkalosis
45
Q

Mineralcorticoid control of ECF volume

A

Decreases ECF volume

46
Q

Mineralcorticoids control of plasma K+ concentration

A

Increases potassium concentration by increasing aldosterone secretion and potassium excretion by kidneys

47
Q

Aldosterone deficiency

A
  1. Decrease Sodium reabsorption
  2. Decrease potassium and hydrogen excretion
  3. Decrease ECF volume (contraction)
  4. Hypotension
  5. Hyperkalemia
  6. Metabolic acidosis
48
Q

Mineralcorticoids bind _______ and ______ with equal affinity

A

Cortisol and aldosterone

49
Q

Why doesn’t cortisol overwhelm aldosterone mineralcorticoids since it’s concentration is 1000X higher than aldosterone?

A

Renal cells convert cortisol to cortisone with 11 beta-hydroxysteroid dehydrogenase

Cortisone has a low affinity for mineralcorticoid receptors

Allows changes in blood levels of aldosterone to be seen in kidney, not masked by high levels of cortisol

50
Q

Adrenal androgens in males play a ______ role

A

Play a minor role because de novo synthesis of testosterone in testes is greater

51
Q

Adrenal androgens in females play a _____ role

A

Major, contributes to pubic and armpit hair and libido

52
Q

2 adrenal hormones converted to testosterone in the testes

A

Dehydroepiandrosterone (DHEA) and androstenedione

53
Q

Andrenogenital syndrome

A

Increases synthesis of adrenal androgens

54
Q

High levels of DHEA and androstenedione result in

A
  1. Masculinization in females (malformed genitalia)
  2. Suppression of gonadal function in both sexes
  3. Early development of pubic/auxiliary hair
  4. Increased urinary levels of 17-ketosteroids
55
Q

21 beta hydroxylase deficiency

A

Increase androgen production

Decreased mineraldcorticoid and glucocorticoids production

56
Q

Addison’s disease

A

Primary adrenocortical insufficiency

57
Q

Cushing’s syndrome

A

Primary adrenal hyperplasia

58
Q

Cushing’s disease

A

Excess ACTH

59
Q

Conn’s syndrome

A

Aldosterone secreting tumor

60
Q

Autoimmmune disease of the entire adrenal cortex

A

Addison’s disease

61
Q

Addison’s disease characteristics

A
  • Decrease synthesis of all adrenocortical hormones (glucocoritcoids, mineralcorticoids, adrenal androgens in women)
  • Hyperpigmentation of the skin
62
Q

Effect of decreased glucocorticoids in Addison’s disease

A

Hypoglycemia, anorexia, weight loss, nausea, vomiting, weakness

63
Q

Decreased mineralcorticoids effects in Addison’s disease

A

Hyperkalemia, metabolic acidosis, hypotension

64
Q

Effects of decreased adrenal androgens in women with Addison’s disease

A

Decreased pubic and auxiliary hair and decreased libido

65
Q

Secondary adrenocortical insufficiency

A
  • insufficient CRH
  • insufficient ACTH (mainly)
  • same symptoms as Addison’s except low ACTH levels and no hyperpigmentation
66
Q

Adrenocortical insufficiency

A
  • All organ systems go awry
  • Cause of death is circulatory collapse is secondary to sodium depletion
  • inadequate food intake, death from hypoglycemia
67
Q

Chronic excess of glucocorticoids due to spontaneous overproduction by cortisol or pharmacological overdose

A

Cushing’s syndrome

68
Q

Characteristics of Cushing’s syndrome

A
  • Hyperglycemia
  • Increase muscle wasting
  • Decrease insulin sensitivity and greater tendency for fat mobilization
69
Q

Physical characteristics of Cushing’s syndrome

A 
-Fat in the face, shoulders, and abdomen
(Moon face, buffalo hump,)
-Striae
-osteoporosis 
-poor wound healing 
-hypertension
-menstrual disorders in females
70
Q

Cushings Disease VS Cushing’s syndrome

A

In disease the ACTH is high

71
Q

Primary hyperaldosteroinism is a characteristic of

A

Conn’s syndrome

72
Q

Primary hyperaldosteronism

A
  • caused by aldosterone secreting tumor
  • Increase ECF volume
  • Increase Sodium and water reabsorption
  • increase hydrogen excretion
73
Q

Treatment of Conn’s syndrome

A

Sprinolactone (aldosterone antagonist) and surgical removal of the tumor

74
Q

21 beta hydroxylase deficiency

A

Unable to make 11-deoxycorticosterone

75
Q

Without 11-deoxycorticosterone

A
  1. Adrenals cant produce mineralcorticoids or glucocorticoids
  2. Increased production of adrenal androgens
  3. High ACTH levels because no negative feedback with low cortisol
76
Q

17 alpha hydroxylase deficiency

A
  1. Decreased androgens and glucocorticoids
  2. Increased 11-deoxycorticosterone and corticosterone (mineralcorticoids)
  3. Decreased aldosterone due to inhibited renin secretion (angiotensin II)
77
Q

Adrenal medulla makes up ______ of adrenal gland

A

10-20%

78
Q

Chromaffin cells have an affinity for

A

Chromium salts

79
Q

Chromaffin cells are

A

Modified postganglionic neurons

80
Q

Adrenal medulla is innervated by

A

Neurons from the intermediolateral horn cells in thoracolumbar spinal cord

81
Q

Plays a crucial role in response to stress

A

Adrenal medulla

82
Q

The adrenal medulla releases mostly

A

Epinephrine

83
Q

How are 90% of catacholamines removed

A

Passage through most capillary beds

84
Q

Medullary hormones effect on heart

A

Increase rate and force of contraction

Increase glycogenolysis

85
Q

Medullary hormone effects on blood vessels

A

Vasoconstriction

86
Q

Medullary hormone effect on adipose metabolism

A

In adipose

-increase lipolysis and blood FFA and glycerol

87
Q

Increase glycogenolysis, gluconeogenesis and blood sugar

A

Medullary hormones on liver metabolism

88
Q

Muscle metabolism changes due to medullary hormones

A

Increase glycogenolysis and lactate and pyruvate release

89
Q

Metabolism changes due to medullary hormones on lungs, stomach, and skin

A

Lungs: dilation of bronchioles
GI: inhibit peristalsis, increase sphincter contraction
Skin: increase sweating

Endocrinology (11 decks)

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