Test 2 Flashcards
The outer zone of the adrenal cortex is called…
Zona Glomerulosa
The middle zone of the adrenal cortex is called…
Zona Fasciculata
The inner zone of the adrenal cortex is called…
Zona Reticularis
The outer zone of the adrenal cortex produces…
Mineralocorticoids (namely ALDOSTERONE)
The middle zone of the adrenal cortex produces…
Glucocorticoids (namely CORTISOL)
The inner zone of the adrenal cortex produces…
Adrenal Androgens (namely DHEA and ANDROSTENEDIONE)
What inhibits Cortosol?
Increased blood cortisol levels
opioids
Somatostatin
The main stimulator in cortisol secretion
Stress, hypoglycemia, surgery, trauma.
Excess cortisol due to a problem in the adrenal cortex (typically a tumor)
Cushing Syndrome
Excess cortisol due to a problem in the anterior pituitary (typically excess ACTH from a tumor)
Cushing Disease
Diminished cortisol secretion (and sometimes also aldosterone) due to a problem in the adrenal cortex (typically autoimmune or certain fungal infections)
Addison Disease (Primary Adrenal Insufficiency)
Hyperpigmentation is a result of elevated levels of ______ which are then converted into ________.
ACTH
α-MSH
a class of anti- hypertensive drugs that block the conversion of angiotensin I into angiotensin II.
ACE inhibitors
Caused by aldosterone- secreting tumor
Conn Syndrome (Primary Hyperaldosteronism)
Production is shunted entirely toward the adrenal androgen pathway, which causes virilization in females.
Congenital 21β-Hydroxylase Deficiency
Production is shunted entirely toward the mineralocorticoid pathway.
Congenital 17α-Hydroxylase Deficiency
Adrenal insufficiency is treated with replacement of glucocorticoid. This is achieved with the oral cortisol __________.
hydrocortisone; Cortef
Low-potency, short-acting GCs
hydrocortisone, cortisone;
Medium-potency, intermediate-acting GCs
prednisone, prednisolone, methylprednisolone, triamcinolone
High-potency, long-acting GCs
betamethasone, budesonide, dexamethasone
lthough hydrocortisone has some mineralocorticoid activity, it is usually not enough for some patients. These patients require the synthetic oral mineralocorticoid_______________.
fludrocortisone (Florinef)
most predominant cells in the parathyroid glands
The principal or chief cells
Some recent evidence suggests that they may be degenerated principal cells.
oxyphil cells
the active form of vitamin D
1,25 dihydroxycholecalciferol
Rickets occurs in children, ___________ in adults
Osteomalacia
protein hormone (32-amino acids) that is synthesized and secreted by the parafollicular cells of the thyroid gland
Calcitonin
A typical attack of hypocalcemic tetany involves muscular spasms in the face
Chvostek’s sign
A typical attack of hypocalcemia Tetany involves contortions of the arms and hands.
Trousseau’s sign
Associated with chronic mucocutaneous candidiasis and primary adrenal insufficiency
Autoimmune polyglandular syndrome
Adequate calcium for Postmenopausal women
approx. 1200 mg
The most widely available calcium supplements are
calcium carbonate and calcium citrate
Calcium supplements interfere with the absorption of______ and _______ _____ and, therefore, these medications should be taken at different times.
iron
thyroid hormone
When is Calcium carbonate absorption better?
With meals
When is calcium citrate absorption better?
While fasted
How does estrogen affect bone?
Osteoblasts also produce a “decoy receptor” called osteoprotegerin (OPG) that binds to RANKL and prevents the RANKL/RANK interaction (thereby causing osteoclastogenesis inhibitory activity).
Estradiol increases production of OPG to diminish bone resorption.
Tissue selective estrogen receptor
modulator (SERM) that has been approved by the FDA for the prevention and treatment of osteoporosis
Raloxifene (Evista)
a humanized monoclonal antibody against RANKL thereby inhibiting osteoclast formation, decreasing bone resorption, increasing BMD and reducing the risk of fracture
Denosumab (Prolia)
Caused by aldosterone- secreting tumor
Conn syndrome
Treatment of Conn syndrome consists of administration of an aldosterone antagonist such as
spironolactone
Examples of ACE inhibitors include
lisinopril and enalapril
