Lectures 16-20

Question 1

What does the Zona Glomerulosa secrete?

Answer 1

mineralocorticoids

Question 2

What does the Zona Fasciculata secrete?

Answer 2

Glucocorticoids

Question 3

What does the Zona Reticularis secrete?

Answer 3

Androgens

Question 4

What would the over-production of mineralocorticoids, glucocorticoids, and catecholamines cause?

Answer 4

Cushing’s syndrom
Conn’s syndrom
Phaeochromocyoma

Question 5

What do GRE’s do?

Answer 5

Glucocorticoid response elements

act as transcription factors

Question 6

How are Glucocorticoids normally transported?

Answer 6

protein bound (90% to corticosteroid binding globulin)
5% are bioavailable

Question 7

How is the synthesis of glucocorticoids regulated?

Answer 7

Corticotropin releasing hormone, on a circadian frame.

Question 8

What do mineralocorticoids do?

Answer 8

Control water and salt balance in the DCT

Facilitates myocardial collagen production

Question 9

What regulates the release of mineralocorticoids?

Answer 9

Renin and water

Question 10

What is the most abundant adrenal androgen?

Answer 10

Dehydroepiandosterone (DHEA)

Question 11

What is the production of adrenal androgens regulated by?

Answer 11

ACTH (not FSH/LH)

Question 12

What is significant about catecholamine receptors?

Answer 12

There are 3 (alphas 1,2, and 3)

They have different effects

Question 13

What are the symptoms of Adrenal insufficiency

Answer 13

Anorexia
Fatigue
Gastrointestinal problems

Question 14

How would you diagnose primary adrenal insufficiency?

Answer 14

low cortisol levels

Question 15

How would you diagnose secondary adrenal insufficiency?

Answer 15

adrenal gland should still respond to the ACTH test (Short Synacthen test)

Question 16

What is the cause of primary adrenal insufficiency?

Answer 16

autoimmune adrenalitis 
(Addison's disease)

Question 17

What is the significance of the cortisone-cortisol shuffle clinically

Answer 17

hydro-cortisone is used to replace cortisol

cortisone acetate replaces cortisone, but it isnt preferred

Question 18

What would you do if a patient has suspected adrenal insufficiency?

Answer 18

inject hydrocortisone immediately

Question 19

WHat are the 4 main signs and symptoms of Cushing’s syndrome?

Answer 19

Purple striae
Muscle atrophy
osteoporosis
Bruising

Question 20

How would Cushing’ syndrome be diagnosed?

Answer 20

The dexamethasone suppression test

Question 21

What are the trends in obesity between twins?

Answer 21

Dizygotics are more likely to have a similar BMI than Monozygotics

Question 22

What affects the levels of Leptin?

Answer 22

An increase in food expenditure and decrease in energy expenditure will increase the secretion of leptin by adipose tissue
This will decrease appetite

Question 23

What might Leptin defficiecny cause?

Answer 23

obesity

Question 24

What would a greater % central abdominal fat correlate to?

Answer 24

A decrease in insulin sensitivity

Question 25

Why would someone with a higher BMI have disproportionately large adipose cells?

Answer 25

Reduced adipogenesis
insulin resistance
adipose inflammation

Question 26

What might increased fatty acid levels be associated with?

Answer 26

reduced glucose uptake by peripheral tissues

increased insulin resistance in skeletal muscel and liver

Question 27

What does Orlistat do?

Answer 27

binds to lipase, decreasing the formation of micelles droplets, decreasing the transfer of fats into epithelial tissue

Question 28

What does GLP-1 do

Answer 28

Glucagon like peptide 1
Increases insulin
decreases glucagon

Question 29

What are the main 3 types of bariatric surgery?

Answer 29

Adjustable gastric band
Roux-en-Y Gastric bypass
Vertical sleeve gastrectomy

Question 30

What is primary adrenal insufficiency caused by?

Answer 30

normally autoimmune adrenalitis

Question 31

What is secondary adrenal insufficiency caused by?

Answer 31

Usually pituitary tumours or their treatment

Question 32

What hormone works anatgonistically to Leptin?

Answer 32

Ghrelin