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CBL endocrine > lecture 4 > Flashcards

lecture 4 Flashcards

1
Q

Adrenal cortex features

A

Stimulates by stress response
Produces steroid hormones derived from steroids (corticosteroids)
Regulation of Na+ and K+ and fluid volume

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2
Q

Zones of the cortex

A

Glomerulosa = aldosterone
Fasciculata = cortisol ( and androgens)
R = androgens
medulla

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3
Q

Medulla hormones

A

Adrenaline and noradrenaline

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4
Q

Cortisol

A

Stress hormone
Secreted from zone fasciculate
Release controlled by CRH/ACTH

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5
Q

Circadian rhythms and CRH

A

CRH secretion synchronised with sleep/wake cycle

Stress induced secretion of CRH increases glucocorticoid/cortisol secretion and overrides rhythms

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6
Q

Actions of cortisol/glucocorticoid

A

provides fuel
protects CVS
depresses inflammation and immune responses

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7
Q

Metabolism - how is it regulated using cortisol .. LOW BLOOD GLUCOSE

A 
Insulin decreases
Glucagon increases 
Growth hormone increases 
Cortisol increases 
Hunger increases
release of fats from white fat
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8
Q

Cortisol effect on CVS

A

Increases contractility and force of contraction
Increases peripheral resistance
Increases effects of noradrenaline and adrenaline
Increases number of angiotensin receptors

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9
Q

Hypertension and cortisol

A

Common In Cushings

Excess cortisol

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10
Q

Hypotension and cortisol

A

Common in Addisons

Deficit of cortisol

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11
Q

Cortisol - inflammatory and immune response

A

Antiiflammaory and immunosuppressive

Inhibits secretion of cytokines, histamine release, proliferation of immune cells and synthesis of antibodies

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12
Q

Therapeutic use of glucocorticoids ( cortisol )

A

reduce inflammation

damp down immune responses

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13
Q

How is cortisol regulated

A

Hypothalamus releases CRH via portal hypophyseal circulation
Anterior pituitary releases ACTH via systemic circulation
Adrenal cortex ( cortisol)

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14
Q

Feedback control of cortisol

A

Time of day ( shift work) - circadian rhythm
Negative feedback
Positive feedback - physical and emotional

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15
Q

AVP =

A

ADH

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16
Q

Aldosterone main function

A

main role is to regulate salt and water in the body, thus having an effect on blood pressure.

17
Q

Aldosteorne is secreted from

A

Adrenal gland - glomerulosa zona

18
Q

How is aldosterone released

A

Low Na stimulates renin release in kidney
Renin cleaves angiotensinogen to Ang I
Ang I converted to Ang II

19
Q

Aldosterone stimulates..

A

Na-K ATPase in collecting ducts
Na reabsorbed from filtrate
K secreted into filtrate
Water retention

20
Q

Corticosteroid receptors

A

Steroids fat soluble

Cytosolic receptors

  • Glucocorticoid receptors - CORTISOL
  • Mineralocorticoid receptors - ALDOSTERONE
21
Q

paths to disregulation fo cortisol

A 
Primary = adrenal cortex - cortisol/aldosterone 
Secondary = Anterior pituitary( ACTH)
Tertiary = hypothalamus ( CRH)
22
Q

Too little cortisol - primary deficit

A

Failure of adrenal cortex to secrete cortisol
Loss of negative feedback on CRH and ACTH secretion
CRH and ACTH increase

23
Q

Too little cortisol - secondary deficit

A

Failure of pituitary to secrete ACTH
Loss of negative feedback
CRH high but ACTH low
Atrophy of adrenal cortex

24
Q

Symptoms of Addisons ( too little cortisol )

A 
Hypotension 
Hypoglycemia 
Hyponatremia 
Hypovolumia 
Hyperpigamnetation 
Hyperkalaemia
25
Q

Hyperkaeamia

A

High K+ Suggests lack of aldosterone

26
Q

Main causes of Addisons

A

Autoimmune destruction of adrenal cortical cells = primary

Chronic glucocorticoid treatment = secondary

Infection
Drugs that inhibit cytochrome p450
Cortisol resistance

27
Q

Treatment ( urgent ) for addisonian crisis

A

High dose IV
Fludrocortisone - mineralocorticoid ( primary)
Glucocorticoid and fluids

Need to restore blood volume, pressure and sugar

28
Q

Cushings disease symptoms

A

Muscle wasting
High blood sugar
Fat deposition
Hypertension

29
Q

Cushings disease

A

ACTH high
Stimulastes MR
Raises blood volume,blood pressure and Na

30
Q

Excess cortisol effects

A

Reduces inflammation - asthma, IBS,
Supresses immune system - MS
Atrophy of zone fascicula ( cortex)

31
Q

Cushings treatment

A

Remove or destroy abdnormal source of ACTH/cortisol

32
Q

Why shouldn’t steroids be stopped suddenly

A

treatment will reduce ACTH secretion via negative feedback
Low ACTH = atrophy of cortex
Tapering off= ACTH can rise, growth of cortex is stimulated

33
Q

What is aldosterone release controlled by

A

Ang II

34
Q

Addisons crisis

A 
Circulatory collapse 
Hypoglycaemia 
Nausea and vomiting 
Weakness 
Depression and fatigue

CBL endocrine (8 decks)

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