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Pharmacology > Part 15: Endocrine & Adrenal Steroids > Flashcards

Part 15: Endocrine & Adrenal Steroids Flashcards

1
Q

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

A

hypothalamus & pituitary

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2
Q

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

A

body & environment

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3
Q

in most cases, hormonal responses aim at maintaining ___

A

homeostasis

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4
Q

what are 2 important roles of the hypothalamus & pituitary?

A
  1. stimulating the secretion of hormones

2. tight regulation of hormone secretion

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5
Q

in general, the ____ gland secretes “releasing hormones”

A

hypothalamus

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6
Q

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

A

releasing hormones from the hypothalamus

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7
Q

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

A

endocrine

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8
Q

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

A

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

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9
Q

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

A

adrenocortocotropin hormone

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10
Q

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

A

TSH (thyroid stimulating hormone)

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11
Q

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

A

LH and FSH

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12
Q

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

A

stressful

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13
Q

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

A

corticotropin releasing hormone (CRH)

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14
Q

corticotropin RH (CRH) is also known as ____

A

corticotropin releasing factor (CRF)

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15
Q

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

A

ACTH (adrenocorticotropic hormone); cortisol

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16
Q

cortisol in the systemic circulation acts to combat ___ stimuli

A

stressful

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17
Q

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

A

negative

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18
Q

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

A

less

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19
Q

CRH is released by the ____ in response to stressful stimuli

A

hypothalamus

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20
Q

ACTH is secreted by the ____ and stimulates the ____

A

anterior pituitary; adrenal cortex

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21
Q

cortisol is synthesized in the ____ cells of the adrenal cortex

A

zona fasciculata

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22
Q

in the adrenal cortex, cortisol is made from ____

A

cholesterol

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23
Q

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

A

plasma proteins

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24
Q

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

A

t

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25
Q

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

A

sleep, deprivation, light, stress

26
Q

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

A

corticosteroid-binding globulin (CBG)

27
Q

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

A

intracellular steroid receptors

28
Q

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

A

t

29
Q

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

A

nucleus

30
Q

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

A

glucocorticoids response elements (GREs)

31
Q

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

A

proteins

32
Q

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

A

energy

33
Q

cortisol provides an important regulatory component to the ___ system

A

immune

34
Q

what are the glucocorticoid effects of cortisol?

A

energy metabolism & immune function

35
Q

what are the mineralocorticoid effects of cortisol?

A

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

36
Q

the mineralocorticoid receptor is also known as the ____ receptor

A

aldosterone

37
Q

what is Addison’s disease?

A

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

38
Q

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

A

hormone supplementation

39
Q

what is Cushing’s syndrome?

A

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

40
Q

what is the treatment for Cushing’s disease?

A

typically surgical removal of the adrenal glands and then hormone replacement

41
Q

t/f Addison’s disease is an autoimmune disease

A

t

42
Q

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

A

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

43
Q

how can Addison’s disease cause electrolyte imbalances?

A

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

44
Q

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

A

exogenous

45
Q

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

A

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

46
Q

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

A

t

47
Q

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

A

t

48
Q

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

A

depression; other endocrine disorders

49
Q

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

A

t

50
Q

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

A

t

51
Q

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

A

t

52
Q

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

A

aldosterone

53
Q

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

A

t

54
Q

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

A

because this also increases glucocorticoid activity

55
Q

which corticosteroid has high mineralocorticoid activity?

A

fludrocortisone

56
Q

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

A

t

57
Q

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

A

t

58
Q

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

A

t

59
Q

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

A

t

60
Q

t/f many presenting features of endocrine disorders overlap

A

t

61
Q

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

A

blood tests

62
Q

what is the focus of treatment for endocrine disorders?

A

replacing or reducing hormones to get to a normal level

Pharmacology (49 decks)

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