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Physiology 1 > Steroids Of The Adrenal Cortex > Flashcards

Steroids Of The Adrenal Cortex Flashcards

1
Q

What are the three types of steroids stimulated by the adrenal cortex?

A

Glucocorticoids, mineralocorticoids and androgens

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2
Q

What is the syndrome associated with excess cortisol?

A

Cushing’s syndrome

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3
Q

What is the disease associated with adrenal insufficiency?

A

Addison’s disease

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4
Q

How does functional zonation happen in the adrenal cortex?

A

Layer specific enzymes -> different hormones made in each layer

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5
Q

Where does the blood flow from/to in the adrenal cortex?

A

Outer cortex to inner medulla

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6
Q

What is the action of mineralocorticoids?

A

Salt and water balance

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7
Q

What are the actions of glucocorticoids?

A

Metabolism and immune action

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8
Q

What increases release of glucocorticoids?

A

Stress

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9
Q

What are the actions of androgens?

A

Weak sex steroids

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10
Q

What does aldosterone do?

A

Selectively increases sodium reabsorption in the distal tubule

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11
Q

What does aldosterone promote?

A

Potassium secretion

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12
Q

What is an aldosterone receptor?

A

Mineralocorticoid receptor

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13
Q

Why do you have to convert cortisol -> cortisone?

A

Mineralocorticoid receptor has equal affinity for cortisol and aldosterone, but cortisol is more ubiquitous so to get aldosterones effects you have to get rid of cortisol

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14
Q

What causes the syndrome of apparent mineralocorticoid excess (AME)?

A

Rare inactivating mutation of cortisol -> cortisone enzyme

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15
Q

What is the metabolic design of cortisol?

A

Store glucose

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16
Q

What does cortisol do to store glucose?

A

Promote lipolysis, gluconeogenesis, insulin resistance in muscles, proteolysis

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17
Q

Why does cortisol promote proteolysis?

A

So the amino acids are available as a substrate for gluconeogenesis

18
Q

Why does cortisol promote lipolysis?

A

Stored fats being used as energy

19
Q

Why does cortisol promote insulin resistance in muscles?

A

To stop muscle metabolising glucose and instead use fats

20
Q

What can excess cortisol lead to (metabolically)?

A

Hyperglycaemia and lipogenesis

21
Q

What gives rise to the alpha and beta isoforms of the glucocorticoid receptor?

A

Alternate splicing

22
Q

What does the glucocorticoid do?

A

Transactivation and transrepression

23
Q

What is transactivation?

A

Enhances transcription of the target gene

24
Q

What does transrepression do?

A

Represses transcription of target gene

25
Q

What is ACTH synthesised from?

A

Pro-opiomelanocortin prohormone

26
Q

What type of receptor is the ACTH receptor?

A

Melanocortin

27
Q

What is the function of ADH?

A

Maintain pure, solute free water

28
Q

What does excess ADH cause?

A

Excess fluid retention -> dilution of ECF and hyponatremia

29
Q

What may excess circulating ACTH cause (and why)?

A

Skin pigmentation because ACTH can also bind to other melanocortin receptors

30
Q

What are the clinical features of addisons?

A

Low circulating adrenal steroids
high ACTH and plasma renin
plasma [Na+] normal -low
plasma [K+] normal to high

31
Q

What is Addison’s disease caused by?

A

Primary adrenal failure due to autoimmune

32
Q

What are the symptoms of Addison’s disease?

A

Anorexia, weakness, fatigue, hyperpigmentation, GI symptoms and hypotension

33
Q

What may the clinical features of Addison’s disease be exposed by?

A

Significant stressors or illness

34
Q

What is the treatment for Addison’s?

A

Cortisol replacement

35
Q

What are the two causes of Cushing’s syndrome?

A

Excess cortisol or excess glucocorticoid drugs

36
Q

What are the clinical features of Cushing’s syndrome?

A

Hypertension, hyperglycaemia, central obesity, fatigue, muscle weakness, virilisation and depression, mood or psychiatric disturbances

37
Q

What are the two steps of Cushing’s syndrome diagnosis?

A

Confirm hypersecretion of cortisol, then determine the cause

38
Q

How can you determine the cause of Cushing’s syndrome?

A

Plasma ACTH or dexamethasone suppression test

39
Q

How can you confirm hypersecretion of cortisol?

A

24hr urinary cortisol, or measure the cortisol at lowest point of secretion (round midnight)

40
Q

How do you distinguish between cushings disease and syndrome?

A

Disease has an identifiable cause, syndrome doesnt

Physiology 1 (65 decks)

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