Part 15: Endocrine & Adrenal Steroids

Question 1

most endocrine organs are regulated by hormones released by the ____ and ____ glands

Answer 1

hypothalamus & pituitary

Question 2

when the hypothalamus receives input from the ___ and ___, hormones are released in response to the detected situation

Answer 2

body & environment

Question 3

in most cases, hormonal responses aim at maintaining ___

Answer 3

homeostasis

Question 4

what are 2 important roles of the hypothalamus & pituitary?

Answer 4

1. stimulating the secretion of hormones

2. tight regulation of hormone secretion

Question 5

in general, the ____ gland secretes “releasing hormones”

Answer 5

hypothalamus

Question 6

the pituitary gland is stimulated by the ______ to secrete stimulating hormones

Answer 6

releasing hormones from the hypothalamus

Question 7

pituitary hormones can go on to ____ glands to secrete their hormones

Answer 7

endocrine

Question 8

what is the main role of the multi-step hormone processes?

Answer 8

to tightly regulate the amount of hormone secreted and available to act on target tissues

Question 9

the hypothalamus hormone, CRH (corticotropin RH) caused the release of the _____ pituitary hormone

Answer 9

adrenocortocotropin hormone

Question 10

the hypothalamus hormone, TRH (thyrotropin RH) causes the release of the _____ pituitary hormone

Answer 10

TSH (thyroid stimulating hormone)

Question 11

the hypothalamus hormone, GnRH (gonadotropin RH) causes the release of the ___ and ____ pituitary hormones

Answer 11

LH and FSH

Question 12

what type of stimuli triggers the hypothalamus-pituitary-adrenal (HPA) axis?

Answer 12

stressful

Question 13

when stressful stimuli are received by the hypothalamus, ____ hormone is released

Answer 13

corticotropin releasing hormone (CRH)

Question 14

corticotropin RH (CRH) is also known as ____

Answer 14

corticotropin releasing factor (CRF)

Question 15

when CRH stimulates the anterior pituitary, ____ hormone is released to act on the adrenal glands to release ____

Answer 15

ACTH (adrenocorticotropic hormone); cortisol

Question 16

cortisol in the systemic circulation acts to combat ___ stimuli

Answer 16

stressful

Question 17

cortisol secretion is on a ___(+/-) feedback loop

Answer 17

negative

Question 18

more cortisol secretion leads to ____ (more or less) CRH and ACTH

Answer 18

less

Question 19

CRH is released by the ____ in response to stressful stimuli

Answer 19

hypothalamus

Question 20

ACTH is secreted by the ____ and stimulates the ____

Answer 20

anterior pituitary; adrenal cortex

Question 21

cortisol is synthesized in the ____ cells of the adrenal cortex

Answer 21

zona fasciculata

Question 22

in the adrenal cortex, cortisol is made from ____

Answer 22

cholesterol

Question 23

cortisol is highly lipophillic, so it must be transported in the blood by being bound to ___

Answer 23

plasma proteins

Question 24

t/f the normal plasma levels of cortisol fluctuate throughout the day to help in normal body processes

Answer 24

t

Question 25

cortisol secretion can be affected by ___, ___, ___, ___ and various disease states

Answer 25

sleep, deprivation, light, stress

Question 26

cortisol circulates in the blood by being bound to ____ type plasma proteins

Answer 26

corticosteroid-binding globulin (CBG)

Question 27

once cortisol reaches the target tissue, it diffuses through plasma membranes and binds to ____ receptors

Answer 27

intracellular steroid receptors

Question 28

t/f lipophilic drugs like cortisol can pass through plasma membranes passively

Answer 28

t

Question 29

the activated receptor-cortisol complex dimerizes and translocates to the _____ where gene regulation is modified to influence body processes

Answer 29

nucleus

Question 30

the binding of cortisol to the glucocorticoid receptor results in the binding of ____ to regulatory regions of DNA

Answer 30

glucocorticoids response elements (GREs)

Question 31

when cortisol binds and alters gene transcription, this leads to altered levels of ____ made by the cell

Answer 31

proteins

Question 32

at a systems level, cortisol signalling contributes to the balance of ___ metabolism

Answer 32

energy

Question 33

cortisol provides an important regulatory component to the ___ system

Answer 33

immune

Question 34

what are the glucocorticoid effects of cortisol?

Answer 34

energy metabolism & immune function

Question 35

what are the mineralocorticoid effects of cortisol?

Answer 35

release of aldosterone by the adrenal gland, which is a potent agonist of mineralocorticoid receptors

Question 36

the mineralocorticoid receptor is also known as the ____ receptor

Answer 36

aldosterone

Question 37

what is Addison's disease?

Answer 37

condition where the adrenal cortex does not produce sufficient cortisol or aldosterone

Question 38

what is part of the treatment for Addison's disease?

Answer 38

hormone supplementation

Question 39

what is Cushing's syndrome?

Answer 39

condition where levels of cortisol are chronically elevated, causing many systemic problems

Question 40

what is the treatment for Cushing's disease?

Answer 40

typically surgical removal of the adrenal glands and then hormone replacement

Question 41

t/f Addison's disease is an autoimmune disease

Answer 41

t

Question 42

what are some of the symptoms of Addison's disease?

Answer 42

muscle weakness, fatigue, weight loss, hypotension, and inability to initiate a stress response, which can cause a patient to go into shock if they experience acute stress

Question 43

how can Addison's disease cause electrolyte imbalances?

Answer 43

adrenal insufficiency results in reduced levels of other adrenal hormones like aldosterone, which impacts electrolyte excretion / absorption in the kidneys

Question 44

treatment of Addison's disease involves replacing adrenal hormones with ____ hormones

Answer 44

exogenous

Question 45

what is the difference between cushing's syndrome and cushing's disease?

Answer 45

in cushing's disease the excess cortisol is caused by an ACTH-producing pituitary tumour

Question 46

t/f pituitary tumours that produce ACTH are not regulated by negative feedback

Answer 46

t

Question 47

t/f cushing's syndrome can occur when a tumour in the adrenal gland causes abnormally high levels of cortisol

Answer 47

t

Question 48

some chronic diseases, like ___ and ___ may cause higher cortisol levels, resulting in Cushing's like effects

Answer 48

depression; other endocrine disorders

Question 49

t/f if the pituitary or adrenal glands need to be removed due to cushing's, patients will require hormone replacement

Answer 49

t

Question 50

t/f patients who have their pituitary and/or adrenal gland removed often present as of the have Addison's disease

Answer 50

t

Question 51

t/f hormone replacement for Addison's or Cushing's where the adrenal glands, both glucocorticoid and mineralocorticoid effects need to be replaced

Answer 51

t

Question 52

which has greater potency at the mineralocorticoid receptor, cortisol or aldosterone?

Answer 52

aldosterone

Question 53

t/f a decrease in aldosterone will cause a decrease in mineralocorticoid activity

Answer 53

t

Question 54

if more mineralocorticoid activity is needed, why is it not the best idea to just increase the dosing of hydrocortisone?

Answer 54

because this also increases glucocorticoid activity

Question 55

which corticosteroid has high mineralocorticoid activity?

Answer 55

fludrocortisone

Question 56

t/f the high mineralocorticoid activity of fludrocortisone can replace the actions of aldosterone and facillitate more fluid & electrolyete retention

Answer 56

t

Question 57

t/f fludrocortisone is so potent that it only requires small amount of effect

Answer 57

t

Question 58

t/f hormone secretion & regulation are critical to maintain overall health

Answer 58

t

Question 59

t/f disruptions in one endocrine systems can cause effects in other systems

Answer 59

t

Question 60

t/f many presenting features of endocrine disorders overlap

Answer 60

t

Question 61

when presenting factors of endocrine disorders overlap, what can be done to determine the pathway responsible?

Answer 61

blood tests

Question 62

what is the focus of treatment for endocrine disorders?

Answer 62

replacing or reducing hormones to get to a normal level