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Endocrinology > Lec 10 - Adrenal Glands > Flashcards

Lec 10 - Adrenal Glands Flashcards

1
Q

three layers in cortex of adrenal gland

A

zona glomerulosa
zona fasciculata
zona reticularis

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2
Q

the 2 corticosteroid hormones made in adrenal gland

A

mineralcorticoids
glucocorticoids

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3
Q

where is mineralcorticoids produced

A

zona glomerulosa

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4
Q

where is glucocorticoids produced

A

zona fasciculata

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5
Q

what does zona reicularis produce

A

precursors to androgens

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6
Q

what is main mineralcorticoid

A

aldosterone

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7
Q

whatis main glucocorticoid

A

cortisol

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8
Q

what do all corticosteroids start off as

A

cholesterol

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9
Q

what is rate limiting step in steroid biogenesis

A

first step = cholesterol to pregnenolone

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10
Q

2 mechanisms of action of glucocorticoid

A

genomic and non genomic

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11
Q

in the cell, what is glucocorticoid receptor linked with

A

heat shock proteins (molecular chaperones)

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12
Q

when steroid receptor complex binds to response elemen, what action does it have

A

alters protein production

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13
Q

how is non genomic different to genomic

A
  • much faster
  • response to stress
  • binds to Gi GPCR in membrane
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14
Q

how does non genomic action work

A

Gi
decreases cAMP production
decreased Ca2+ into cell
and increased K+ out of cell

= decreased excitability

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15
Q

why do GCs have more widespread effects

A

more receptors throughout the body

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16
Q

what are the general effects of GCs

A

controls metabolic effects
anti inflammatory effects
immunosuppresive effects

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17
Q

effects of MCs

A

controls water and electrolyte balance
and
blood pressure homeostasis

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18
Q

which pituitary gland does corticotropin releasing hormone act on

A

anterior

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19
Q

what does ant pituitary release

A

adrenocorticotropic hromone
ACTH

20
Q

how does cortisol -vely feedback

A

acts on APG
and Hypothal

21
Q

how does ACTH trigger cortisol synth and release

A

binds to Gs receptor
inc cAMP
inc PKA
binds to response elements
which allows synthesis of cortisol

22
Q

3 wayss GCs have antiinflammatory effects

A

Stabilises lysosomal membranes

Decreases permeability of capillaries

Decreases migration of white blood cells (and release of prostaglandins, cytokines etc)

23
Q

3 more direct effects on immune system that have anti inflammatory effects

A
  • Suppression of the immune system by
    Reduction in T cells and antibodies
  • Reduction of fever by
    reduces production of IL-1
  • Rate of healing as it increases
    Amino acids, glucose, fatty acids available for repair of tissues.
24
Q

how can GCs be used therapeutically (anti inflammatory effects)

A

Blocks inflammatory response in allergic reactions
Decreases white blood cells in blood

Prevents rejection of transplanted tissues and organs
Suppression of immune system

25
Q

metabolic effects of GCs

A
  • Indicates to catecholamines to exert lipolytic effects
  • Indicates to glucagon to exert calorigenic effects
  • Increased gluconeogenesis, particularly in the liver
    -Increased storage of glycogen in liver and in muscle
  • Uptake and use of glucose in muscle and adipose tissue decreased
  • reduction in protein stores
  • increased liver and plasma AAs
26
Q

how does aldosterone increase blood pressure

A

Causes retention of Na+
Increased release of potassium
In renal tubular epithelial cells

27
Q

how can aldosterone alter water/electrolyte balance

A
  • controls Na+ and K+ transport in
    Salivary glands
    Sweat glands
    Intestines (colon)
28
Q

name a competitive inhibitor of MC receptors

A

Spironolactone
= used as diuretic, and hypertensive effects

29
Q

what causes increase in MC release

A
  • Increased K+ in kidney tubules
  • Increased activity of renin-angiotensin system
  • ACTH
30
Q

how do MCs genomic effects work

A
  • when it acts on nuclear receptors
  • increases Na+ channel proteins
  • and Na/K ATPase increases
    (= allows increased absorption of Na and release of K)
31
Q

which synthetic steroids have both GC and MC activity

A
  • Hydrocortisone
  • Prednisolone, prednisone
32
Q

which synthetic steroids have pure GC activity

A

Dexamethasone
and others but jus allow it man

33
Q

which synthetic steroids have pure MC activity

A

Fludrocortisone

34
Q

disorder from excessive cortisol release

A

Cushing’s Syndrome

35
Q

what can cushings syndrome be caused by

A
  • Tumour of the pituitary gland, adrenal glands
  • Tumours or cancer arising elsewhere in the body (ectopic ACTH producing tumors)
36
Q

what disorder caused by INADEQUATE LEVELS OF CORTISOL

A

Addisons disease

37
Q

causes of addisons disease

A

Adrenal insufficiency due to adisorderof the adrenal glands themselves (primary adrenal insufficiency)

Inadequate secretion of ACTH by the pituitary gland (secondary adrenal insufficiency)

38
Q

what used to treat cushings

A

GC receptors antagonists
Mifepristone

39
Q

why does mifeprestone need to be used carefully in women

A

is also a progesterone receptor antagonist

40
Q

what is new GC receptor antagonist that is in clinical trials

A

Relacorilant
selectively binds to the GR without anti-progesteronereceptor effects

41
Q

addisons disease symptoms

A

Appetite loss
Discolouration of the skin
Dehydration
Increased thirst and need to urinate frequently
Salt cravings
Oligomenorrhoea
No energy or motivation, low mood
Sore / painful, weak muscles and joints

42
Q

how is addisons disease treated

A
  • hydrocortisone
  • prednisone
    etc
    used to replace cortisol
43
Q

what is used to replace aldosterone in aldosterone deficiency

A

Fludrocortisone acetate

44
Q

where can steroids have side effects

A
  • muscle disease
  • bone impairment
  • skin diseases
  • oculopathy
  • cardiovasc diseases
  • CNS disorders
  • metabolic
45
Q
A

Endocrinology (25 decks)

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