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Neuroendocrine > Hypothalamic and Pituitary relations part 2 > Flashcards

Hypothalamic and Pituitary relations part 2 Flashcards

1
Q

Where are the Adrenal Glands located?

A

Above the kidneys

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2
Q

What does the Hypothalamus release to the Anterior Pituitary in the HPA axis?

A

CRH

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3
Q

What does the Anterior Pituitary release to the Adrenal cortex in the HPA axis?

A

ACTH

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4
Q

What does the Adrenal cortex release in response to ACTH?

A

Cortisol

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5
Q

HPA axis

A

Hypothalamic-Pituitary-Adrenal Axis

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6
Q

What are the main functions of Cortisol?

A

Immune suppression
Gluconeogenesis
Protein Catabolism
Lipolysis

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7
Q

What activates the Hypothalamus to release CRH?

A

Stress and the Circadian Rhythm

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8
Q

Cortisol is released due to what acting on the Hypothalamus?

A

Stress and the Circadian Rhythm

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9
Q

Where does Cortisol have negative feedback?

A

At the Anterior pituitary (ACTH) and at the Hypothalamus (CRH)

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10
Q

Do Androgens have negative feedback?

A

NO

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11
Q

What are the 3 zones of the Adrenal Cortex?

A

Zona Granulosa
Zona Fasciculata
Zona Reticularis

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12
Q

Zona Granulosa releases?

A

Mineralcorticoids - Aldosterone

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13
Q

Zona Fasciculata releases?

A

Glucocorticoids - Cortisol

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14
Q

Zona Reticularis releases?

A

Androgens - secondary sex characteristics

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15
Q

When are ACTH and Cortisol secretion rates the highest?

A

In the morning

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16
Q

When are ACTH and cortisol secretion rates the lowest?

A

In the evening

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17
Q

What activates the release of Aldosterone?

A

Low sodium/High potassium OR

LOW BP

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18
Q

Describe the pathway for how to release Aldosterone from the Adrenal Cortex

A
  • Low sodium/High potassium or LOW BP act on the Kidney to release Renin
  • Renin activates Angiotensin to Angiotensin 1 which then goes to Angiotensin 2
  • Angiotensin 2 acts on the Zona Glomerulosa to release Aldosterone
  • Increased sodium/water absorption and increased BP
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19
Q

What does the kidney release to help activate Aldosterone secretion?

A

Renin

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20
Q

Where is the Angiotensin cascade found?

A

Liver

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21
Q

Where does low sodium/high potassium or Low BP act to activate Aldosterone release?

A

Kidney

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22
Q

Hypersecretion of glucocorticoids (cortisol)

A

Cushing’s Disease

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23
Q

Symptoms of Cushing’s Disease

A

Truncal obesity, buffalo hump, moon face, purple striae, high BP, easy bruising

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24
Q

What test can distinguish what is causing the increased cortisol levels for Cushing’s Disease?

A

High-Dose Dexamethasone Suppression Test

25
Q

What is the expected response of the HIGH-Dose Dexamethasone Suppression Test?

A

Decreased levels of ACTH that lead to decreased Cortisol levels

26
Q

Describe the results of Cushing’s Disease caused by an Adrenal Tumor

A

Low CRH
Low ACTH
HIGH Cortisol

27
Q

Describe the results of Cushing’s Disease caused by an Anterior Pituitary Tumor

A

Low CRH
HIGH ACTH
HIGH Cortisol

28
Q

Describe the results of Cushing’s Disease caused by an Ectopic secreting ACTH tumor

A

Low CRH
Low ACTH at pituitary
HIGH ACTH from another source
HIGH cortisol

29
Q

Describe the results of Cushing’s Disease caused by exogenous glucocorticoid drugs

A

Low CRH
Low ACTH
LOW cortisol

30
Q

Why are all outputs low if Cushing’s Disease is caused by exogenous glucocorticoid drugs?

A

Exogenous glucocorticoids have the same negative feedback loop as real cortisol, thus all levels of the hormones will be low from their regular source

31
Q

What may atrophy due to exogenous glucocorticoid drug intake?

A

Adrenal cortex cells that normally produce cortisol (fasciulata)

32
Q

What are a few exogenous glucocorticoid drugs?

A

Prednisone
Methylprednison
Dexamethasone

33
Q

What is the action of Aldosterone?

A

Increase sodium and water absorption and Increase BP

34
Q

Increased levels of ACTH can lead to?

A

Hyperpigmentation (skin darkening)

35
Q

Hyposecretion of mineralcorticoids and glucocorticoids

A

Addison’s Disease

36
Q

Addison’s disease may also be known as

A

Adrenal Gland insufficiency

37
Q

What test can be used to detect Adrenal Gland insufficiency?

A

Cosyntropin (synthetic ACTH) stimulation test

38
Q

Low morning cortisol levels (normal is high) can confirm what?

A

Adrenal gland insufficiency

39
Q

If morning cortisol levels are low and ACTH is high, what is the diagnosis?

A

Primary Adrenal Gland insufficiency

40
Q

What are the levels of Cortisol and Aldosterone for Primary Adrenal Gland Insufficiency?

41
Q

If morning cortisol levels are low and ACTH is low/normal, what is the diagnosis?

A

Secondary/Tertiary Adrenal Gland insufficiency

42
Q

What are the levels of Cortisol and Aldosterone for Secondary/Tertiary Adrenal Gland insufficiency?

A

LOW cortisol

ALDOSTERONE IS NORMAL due to Renin system being unaffected in the liver

43
Q

Main physical sign of Primary adrenal gland insufficiency?

A

Hyperpigmentation - due to high ACTH and low cortisol

44
Q

Excessive release of Aldosterone, may be due to Adenoma in Adrenal cortex

A

Primary Hyperaldosteronism

45
Q

Excessive release of Renin that causes excess Aldosterone

A

Secondary Hyperaldosteronism

46
Q

What characterizes congenital enzyme deficiencies relating to the adrenal glands?

A

Enlargement of the adrenal glands due to HIGH levels of ACTH because the cortisol is LOW and thus there is an absence of (-) feedback on ACTH

47
Q

Adrenal Hyperplasia

A

Enlargement of adrenal glands

48
Q

17 alpha enzyme deficiency

A 
HIGH aldosterone = HIGH BP
LOW androgens (sex hormones) = underdeveloped
49
Q

21 beta enzyme deficiency

A 
LOW aldosterone = LOW BP
HIGH androgens (sex hormones) = early puberty, virilization
50
Q

11 beta enzyme deficiency

A 
LOW aldosterone , but somehow HIGH BP
HIGH androgens (sex hormones) = virilization
LOW renin activity
51
Q

What are the levels of cortisol in all congenital enzyme deficiencies for the adrenal cortex?

52
Q

What is virilization?

A

Male hair growth characteristics on females

53
Q

What is a pheochromocytoma?

A

Benign, unilateral tumor that secretes catecholamines

54
Q

Catecholamines

A

Norepinephrine and Epinephrine

55
Q

What stimulates release of NE and E?

A

Acetylcholine

56
Q

How do you diagnose a pheochromocytoma?

A

Increased NE/Epi and increased metabolic byproducts

57
Q

What are the symptoms you would see with increased catecholamines?

A

Sweating, Hypertension, palpitations, headaches

58
Q

Which catecholamine is synthesized in a vesicle?

A

Norepinephrine

Neuroendocrine (47 decks)

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