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NeuroEndo Test 3 > Hypothalamic-Pituitary Relationships and Biofeedback Part 2 - DR L-H > Flashcards

Hypothalamic-Pituitary Relationships and Biofeedback Part 2 - DR L-H Flashcards

1
Q

____ ____ are located immediately above the kidneys.

A

Adrenal glands

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2
Q

Zona glomerulosa secretes ____.

A

aldosterone

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3
Q

Zona fasciculata and zona reticularis secrete _____ and _____.

A

cortisol; androgens

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4
Q

The medulla secretes ______ and ______.

A

epinephrine; norepinephrine

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5
Q

_____ and _____ are rapid responders to stress.

A

Epinephrine and norepinephrine

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6
Q

____ is a longer-acting stress-response steroid hormone that regulates glucose utilization and immune and inflammatory homeostasis.

A

Cortisol

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7
Q

_____ regulates salt and volume homeostasis.

A

Aldosterone

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8
Q

The HPA axis is under negative feedback control by ____.

A

cortisol

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9
Q

Describe the HPA axis.

A

CRH>ACTH>cortisol & androgens

Cortisol inhibits ACTH and CRH.

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10
Q

Cortisol causes immune ____, ______, protein ____, and ____.

A

suppression; gluconeogenesis; catabolism; lipolysis

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11
Q

Cortisol secretion is ___ in the morning and ___ in the late evening.

A

high; low

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12
Q

Describe the regulation of aldosterone secretion.

A

Low blood volume, low BP, low Na+, or high K+ causes increased Angiotensin I production, increasing secretion of aldosterone from the adrenal cortex, causing increased absorption of Na+ and water, and increased K+ excretion, increasing blood volume and BP.

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13
Q

A patient with high plasma cortisol levels and low plasma ACTH levels would have a _____ endocrine syndrome due to a ____ ___.

A

primary; adrenal tumor

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14
Q

Truncal obesity, moon face, buffalo hump, purple striae, and hirsutism are all symptoms of _____ syndrome.

A

Cushing’s

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15
Q

A low-dose dexamethasone tests for _____ _____, but does not specify the source of ACTH overproduction.

A

Cushing’s syndrome

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16
Q

A high-dose dexamethasone tests for ____ ____, specifying CS caused by a pituitary adenoma or a non-pituitary ACTH-secreting tumor.

A

Cushing’s disease

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17
Q

A high-dose dexamethasone test that results in a decrease in ACTH determines that it is _____ _____.

A

Cushing’s disease

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18
Q

A high-dose dexamethasone test that results in no change in ACTH levels determines that it is caused by an ____ ____.

A

ectopic tumor

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19
Q

Iatrogenic Cushing’s syndrome is caused by excess exogenous glucocorticoid drugs which cause the symptoms of excess ____, but in reality, levels of ___ are actually low.

A

cortisol; cortisol

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20
Q

Cushing’s syndrome caused by an adrenal tumor will have high levels of cortisol, and ___ levels of ACTH.

A

low

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21
Q

Cushing’s syndrome caused by an ectopic ACTH secreting-tumor will have high levels of cortisol, ___ levels of pituitary secreting ACTH, and ___ levels of ectopic ACTH.

A

low; high

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22
Q

Cushing’s syndrome caused by an ectopic ACTH-secreting tumor will respond to a high dexamethasone test by doing what?

A

Not changing the levels of ACTH at all.

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23
Q

Cushing’s disease will respond to a high dexamethasone test by doing what?

A

Decreasing ACTH due to negative feedback loop.

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24
Q

Cushing’s disease will have high levels of cortisol and ___ levels of pituitary secreting ACTH.

A

high

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25
Q

What causes Cushing’s disease?

A

A pituitary tumor

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26
Q

An adrenal tumor will cause ___ levels of ACTH.

A

low

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27
Q

A pituitary tumor will cause ___ levels of ACTH.

A

high

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28
Q

An ACTH-secreting ectopic tumor will cause ___ levels of ACTH.

A

very high

29
Q

Exogenous administration of glucocorticoids may ____ adrenal cells that produce cortisol.

A

atrophy

30
Q

_____ disease is an autoimmune response that attacks the adrenal cortex.

A

Addison’s

31
Q

In Addison’s disease, cortisol and aldosterone levels are ___ and ACTH levels are ___.

A

low; high

32
Q

Increased ACTH in a primary adrenal insufficiency causes ______ because ACTH breaks down into MSH.

A

hyperpigmentation

33
Q

Low cortisol and high ACTH is indicative of a _____ adrenal insufficiency.

A

primary

34
Q

Low cortisol and low or normal ACTH is indicative of a ______ or ______ adrenal insufficiency.

A

secondary; tertiary

35
Q

Why is there a low or normal ACTH level in a secondary or tertiary adrenal insufficiency?

A

The renin-angiotensin-aldosterone system still exists.

36
Q

Low cortisol and low aldosterone is indicative of a _____ adrenal insufficiency.

A

primary

37
Q

Low cortisol levels and normal aldosterone levels is indicative of a _____ or ____ adrenal insufficiency.

A

secondary; tertiary

38
Q

Addison’s disease is a ____ adrenal insufficiency.

A

primary

39
Q

There is hyperpigmentation in _____ ____ and in ______ ______.

A

Cushing’s disease; Addison’s disease

40
Q

____ hyperaldosteronism is an excessive release of aldosterone from the adrenal cortex.

A

Primary

41
Q

____ hyperaldosteronism is caused by excessive renin secretion by the juxtaglomerular cells in the kidney.

A

Secondary

42
Q

_____ can be caused by destruction of the adrenal cortex, defects in aldosterone synthesis, or inadequate stimulation of aldosterone secretion.

A

Hypoaldosteronism

43
Q

____ syndrome is an adenoma in the adrenal cortex which causes primary hyperaldosteronism.

A

Conn’s

44
Q

Bilateral adrenal hyperplasia can cause ______ _________.

A

primary hyperaldosteronism

45
Q

Defects in __-___-hydroxylase leads to no androgen release or cortisol release, so presents with no secondary sex characteristics and HTN.

A

17-alpha

46
Q

Defects in __-___-hydroxylase leads to no aldosterone or cortisol release, so presents with ambiguus secondary sex characteristics and hypotension.

A

21-beta

47
Q

Defects in __-___-hydroxylase leads to no aldosterone or cortisol release, so presents with ambiguus secondary sex characteristics and hypertension (due to increased DOC).

A

11-beta

48
Q

A defect in __-___-_____ leads to increased progesterone and 17-OH progesterone.

A

21-beta-hydroxylase

49
Q

A defect in __-___-_____ leads to increased 11-DOC and 11-deoxycortisol.

A

11-beta-hydroxylase

50
Q

A defect in __-___-_____ leads to increased Pregnenolone and progesterone.

A

17-alpha-hydroxylase

51
Q

All congenital adrenal enzyme deficiencies are characterized by an _____ of the adrenal glands.

A

enlargement

52
Q

Enlargement of the adrenal glands can be caused by ____ ACTH stimulation by ____ cortisol.

A

increased; decreased

53
Q

Decreased cortisol synthesis caused negative feedback from the pituitary to increase ___, causing adrenal _____.

A

ACTH; hyperplasia

54
Q

A defect in 17-alpha-hydroxylase causes decreased _______.

A

androstenedione

55
Q

A defect in 21-beta-hydroxylase causes increased ____ and 17-hydroxy-progesterone.

A

renin

56
Q

A defect in 11-beta-hydroxylase causes decreased ____.

A

renin

57
Q

A _____ causes increased secretion of catecholamines (epinephrine and norepinephrine) and presents with HTN, HAs, palpitations, and sweating.

A

pheochromocytoma

58
Q

The adrenal medulla produces catecholamines (______ and ______).

A

epinephrine and norepinephrine

59
Q

Cortisol upregulates PMNT which converts _____ to ____.

A

Norepinephrine to epinephrine

60
Q

The chemical signal for secretion of catecholamine from the adrenal medulla is _____.

A

ACh

61
Q

___ and ___ degrade catecholamines.

A

COMT; monoamine oxidase (MAO)

62
Q

Catecholamines, metanephrines, and VMA can be measured to determine total ______ production.

A

catecholamine

63
Q

The alpha receptors and B3 receptors respond better to ___ than ___.

A

norepinephrine; epinephrine

64
Q

The __ receptor responds equally to NE and E.

A

B1

65
Q

Epinephrine has a higher affinity for the __ receptor.

A

B2

66
Q

Short-term stress causes the adrenal medulla to secrete ______.

A

catecholamines

67
Q

Long-term stress causes the adrenal medulla to secrete ___ and ___.

A

mineralocorticoids; glucocorticoids

68
Q

____ is a mineralocorticoid.

A

Aldosterone

69
Q

____ is a glucocorticoid.

A

Cortisol

NeuroEndo Test 3 (13 decks)

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