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Endocrinology Physiology > Glucocorticoids (Cortisol) > Flashcards

Glucocorticoids (Cortisol) Flashcards

1
Q

Cortisol main effect on carbohydrates?

A
  1. ⬆️glycogenolysis
  2. ⬆️gluconeogenesis
  3. ⬇️insulin
  4. ⬆️glucagon
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2
Q

Cortisol main action in lipids ?

A
  1. Lipolysis

2. ⬆️gluconeogenesis

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3
Q

Cortisol main action on proteins ?

A
  1. Proteolysis

2. Gluconeogenesis

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4
Q

Permissive actions of cortisol?

A
  1. ⬆️Glucagon: ⬆️ glucose levels
  2. ⬆️Catecholamines: ⬆️vasoconstriction and bronchodilation

PERMISSIVE ACTION ON THESE HORMONES

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5
Q

CRH is increased in this particular time?

A
  1. Morning
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6
Q

ACTH precursor?

A
  1. POMC
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7
Q

POMC is a precursor on these hormones ?

A
  1. ACTH
  2. MSH
  3. Beta-endorphins
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8
Q

Cushing syndrome vs Cushing Disease?

A
  1. Cushing syndrome : hypercorticolism

2. Cushing Disease: hypercorticolism due to ⬆️ACTH from pituitary adenoma

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9
Q

How to diagnose hypercorticolism?

A
  1. 24 hour urine free cortisol

2. Overnight low dexamethasone 1mg suppression test—> failure to ⬇️cortisol

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10
Q

How to differentiate between Primary and Secondary Hypercorticolism?

A

Primary: ⬇️ACTH
Secondary: ⬆️ACTH

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11
Q

Etiology difference between Primary and Secondary Hypercorticolism?

A

Primary: Adrenal adenoma, hyperplasia or carcinoma

Secondary:

  1. Cushing Disease (pituitary)
  2. Ectopic ACTH production (SCLC)
  3. Exogenous steroids (⬇️ACTH)
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12
Q

ACTH response with High dose dexamethasone suppression test on Ectopic production?

A
  1. ACTH failure to be suppressed
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13
Q

ACTH response with High dose dexamethasone suppression test on Cushing Disease?

A
  1. Suppression ⬇️ACTH
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14
Q

Primary vs Secondary hypocorticolism ?

A
  1. Primary: Autoimmune destruction 80%. Also acute hemorrhage
  2. Secondary: chronic exogenous steroid use; sudden withdrawal
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15
Q

Other name for Primary Adrenal Insufficiency (Hypocorticolism)?

A
  1. Addison’s Disease
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16
Q

How to make differential diagnosis between Primary and Secondary adrenal insufficiency?

A
  1. Primary: ⬆️ACTH

2. Secondary: ⬇️ACTH

Endocrinology Physiology (14 decks)

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