Hypothalamic and Pituitary Relationships and Biofeedback Part 2 Flashcards
What does the Zona glomerulosa secrete?
Aldosterone
What does the zona fasciculata and zona reticularis secrete?
Cortisol and androgens (DHEAS)
What do the medulla chromaffin cells secrete?
Epi and NE
The hypothalamic, pituitary, adrenal (HPA) axis is under negative feedback control by?
Cortisol
What is cortisol’s action on the immune system?
Suppression
What is cortisol’s action on the liver?
Gluconeogenesis
What is cortisol’s action on muscle?
Protein catabolism
What is cortisol’s action on adipose tissue?
Lipolysis
When are the secretory rates of cortisol high and low?
High in morning and low at night
Moon face, buffalo hump, excess weight gain in abdomen, and dark red or purple stretch marks are signs of what condition?
Cushing’s syndrome
What type of dexamethasone suppression test differentiates patients with cushing syndrome of any cause from patients who do not have it?
Low-dose
In a low dose dexamethasone suppression test what indicates cushing’s syndrome?
No ACTH suppression
What type of dexamethasone suppression test differentiates patients with cushing syndrome caused by pituitary ACTH secreting tumor or not?
High-dose
In a high dose dexamethasone suppression test, low ACTH means?
Pituitary tumor
In a high dose dexamethasone suppression test, no change in ACTH means?
Ectopic tumor
Iatrogenic cushing’s syndrome is caused by?
Exogenous glucocorticoid excess
What is derived from post-translational processing of pro-opiomelanocortin (POMC)?
ACTH
Increased ACTH and hyperpigmentation can be seen in what condition?
Addison’s disease
Cosyntropin (synthetic ACTH) stimulation test is used to detect?
Adrenal gland insufficneincy
Both cortisol and aldosterone secretion is decreased in what type of adrenal insufficiency?
Primary adrenal insufficiency (something wrong at adrenal cortex)
Cortisol is decreased but renin-angiotensin-aldosterone axis is still active in what type of adrenal insufficiency?
Secondary or tertiary adrenal insufficiency (something wrong at anterior pituitary or Hypothalamus)
An adrenal hemorrhage such as Waterhouse-Friderichsen syndrome, tuberculosis, or N. meningitidis can cause?
Addison’s disease (primary adrenal insufficiency)
Fludrocortisone is used as a treatment of adrenal insufficiency to replace?
Aldosterone
Corticosteroids such as hydrocortisone, prednison, or dexamethasone are used as a treatment of adrenal insufficiency to replace?
Cortisol
Patients with increased plasma cortisol, decreased plasma CRH, decreased plasma ACTH, and no hyperpigmentation results in what disorder?
Primary adrenal excess
Patients with increased plasma cortisol, decreased plasma CRH, increased plasma ACTH, and hyperpigmentation results in what disorder?
Secondary pituitary excess
Patients with decreased plasma cortisol, increased plasma CRH, increased plasma ACTH, and hyperpigmentation results in what disorder?
Primary deficiency
Patients with decreased plasma cortisol, increased plasma CRH, decreased plasma ACTH, and no hyperpigmentation results in what disorder?
Secondary deficiency
Patients with decreased plasma cortisol, decreased plasma CRH, decreased plasma ACTH, and no hyperpigmentation results in what disorder?
Steroid administration (synthetics other than cortisol)
Excessive release of aldosterone from the adrenal cortex such as Conn’s is seen in?
Primary hyperaldosteronism
Adenoma in the adrenal cortex is seen in what condition?
Conn’s syndrome
Excessive renin secretion by the juxtaglomerular cells in the kidney is seen in?
Secondary hyperaldosteronism
Destruction of the adrenal cortex, defects in aldosterone synthesis, and inadequate stimulation of aldosterone secretion is seen in?
Hypoaldosteronism
An increase in plasma aldosterone concentration (PAC) and decrease in plasma renin activity (PRA) results in a ratio that is used to detect?
Primary hyperaldosteronism
When cholesterol is stimulated by 21-hydroxylase, 11-hydroxylase, 18-hydroxylase, and then 18-oxidase it results in what hormone?
Aldosterone
When cholesterol is stimulated by 17-hydroxylase, 21-hydroxylase, and 11-hydroxylase it results in what hormone?
Cortisol
The mineralocorticoid receptor is protected from activation by cortisol by what enzyme?
11beta-HSD2
All congenital adrenal enzyme deficiencies are characterized by an enlargement of both adrenal glands due to?
Increased ACTH stimulation due to decrease in cortisol
What enzyme is deficient in congenital adrenal hyperplasia when mineralocorticoids are increased, cortisol is decreased, sex hormones are decreased, blood pressure is increased, and potassium concentration is decreased?
17alpha
What enzyme is deficient in congenital adrenal hyperplasia when mineralocorticoids are decreased, cortisol is decreased, sex hormones are increased, blood pressure is decreased, and potassium concentration is increased?
21beta
What enzyme is deficient in congenital adrenal hyperplasia when mineralocorticoids are variable, cortisol is decreased, sex hormones are increased, blood pressure is increased, and potassium concentration is decreased?
11beta
Most pheochromocytoma are benign, unilateral adrenal tumors that secret catecholamine that stimulate?
Alpha and beta adrenergic receptors
What upregulates PNMT enzyme?
Cortisol
What is the chemical signal for secretion of catecholamine from the adrenal medulla?
Acetylcholine
What is a major enzyme involved in the degradation of catecholamines?
COMT
Alpha and Beta-3 adrenergic receptors respond better to Epi or NE?
NE
Beta-1 adrenergic receptors respond better to Epi or NE?
Equal
Beta-2 adrenergic receptors respond better to Epi or NE?
Epi
