The Adrenal Gland- Functions and Diseases

Question 1

the adrenal medulla is of _____ origin

Answer 1

ectodermal

Question 2

the adrenal cortex is of _____ origin

Answer 2

epidermal (mesoderm)

Question 3

what does the adrenal cortex secrete

Answer 3

aldosterone
cortisol
androgens

Question 4

what does the adrenal medulla secrete

Answer 4

catecholeamines

Question 5

what is the main secretory product of the zona glomerulosa

Answer 5

mineralocorticoid (aldosterone)

Question 6

what is the main secretory product of the zona fasciculata

Answer 6

glucocorticoids (cortisol)

androgens

Question 7

what is the main secretory product of the zona reticularis

Answer 7

glucocorticoids (cortisol)

androgens

Question 8

what is the main product of adrenal medulla

Answer 8

catechole. norep and epin

Question 9

this protein is involved in the rate limiting step in production of steroid hormones by transporting cholesterol into the mitochondria

Answer 9

StAR

Question 10

____ converts cholesterol into ___ (first enzyme)

Answer 10

desmolase, pregnenolone

Question 11

what enzymes are in the aldosterone arm

Answer 11

21 B hydroxylase

11 B hydroxylase

Question 12

what enzyme is in all 3 arms: aldosterone, cortisol, androgens

Answer 12

3B hydroxysteroid dehydrogenase

Question 13

what enzymes are in the cortisol arm

Answer 13

21 B hydroxylase
11B hydroxylase
17 a hydroxylase

Question 14

what enzymes are in the androgen arm

Answer 14

17 a hydroxylase

17,20 lyase

Question 15

a loss of the 21 B hydroxylase enzyme will lead to what?

Answer 15

pregnenolone sent to make androgens, no negative feedack for sex hormones

• virulization of fetus
• lose cortisol
• hyponatremia and hypovolemia (no aldost)
• congenital adrenal hyperplasia (95% of cases)

Question 16

17a hydroxylase deficiency

Answer 16

• pregnenolone is directed towards mineralocorticoid synthesis
• lose secondary sex characteristics

Question 17

ACTH is derived from post-translational processing of ____

Answer 17

POMC

Question 18

POMC is broken down into ___ and ___ one of which increases __

Answer 18

ACTH and a-MSH

-a-MSH increases melanin synthesis

Question 19

cortisol has a negative feedback on what

and what kind of feedback loop is this (long or short)

Answer 19

hypothalamus (-) CRH
Anterior pituitary (-) ACTH

-long loop negative feedback

Question 20

when is cortisol released the most?

Answer 20

in the morning and is around 20 mircrograms/dl

Question 21

what can exogenous administration of cortisol due to certain cells

Answer 21

may shut down ACTH production and adrenal cells that produce cortisol atrophy

Question 22

what does exogenous cortisol do to CRH,ACTH,Cortisol

Answer 22

decreases all of them

Question 23

cushings syndrome is what and has what effects on CRH, ACTH, and cortisol

Answer 23

SYNDROME: tumor of the adrenal gland, unregulated secretion of cortisol

-decreases CRH and ACTH

Question 24

cushings disease is what and has what effects on CRH, ACTH, and cortisol

Answer 24

DISEASE: tumor of the anterior pituitary

• increased ACTH, and cortisol
• decreased CRH
• ACTH has trophic effect on adrenal gland too

Question 25

addison's disease and cortisol and what is primary vs secondary

Answer 25

causes hypocortisolism - primary is autoimmune attack of adrenal gland - secondary is from chronic exogenous glucocorticoid treatment

Question 26

cushings syndrome symptoms

Answer 26

buffalo hump on back of neck moon face excess weight gain in abdomen dark red or purple stretch marks

Question 27

angiotensin ___ can constrict blood vessels to increase BP

Answer 27

II

Question 28

what is the direct effect of aldosterone secretion

Answer 28

ACTH

Question 29

what is the secondary stimulation of aldosterone secretion

Answer 29

angiotensin II

Question 30

steps in action of aldosterone in renal sodium resab

Answer 30

1) aldosterone from blood enters P cell of distal nephron and binds aldosterone receptor 2) hormone-receptor complex goes to nuclues and txn occurs for mRNA 3) translation of mRNA to make epithelial sodium channels and potassium channels - potassium out - sodium in 4) alters the activity of the Na+/K+ ATPase at the basolateral end to pump out sodium and bring in more K+

Question 31

conn's syndrome

Answer 31

primary hypealdosteronism, adenoma in the adrenal cortex

Question 32

secondary hyperaldosteronism

Answer 32

excessive renin secretion by the juxtaglomerular cells in the kidney

Question 33

hypoaldosteronism causes (3)

Answer 33

destruction of the adrenal cortex defects in aldosterone synthesis inadequate stimulation of aldosterone secretion

Question 34

what cells of the adrenal medulla produce catecholeamines

Answer 34

chromaffin cells

Question 35

adrenal medulla produces primarly ___ and small amounts of __

Answer 35

epinephrine (80%) | norepinephrine (20%)

Question 36

synthesis of catecholamines

Answer 36

tyrosine-->DOPA-->Dopamine-->norep-->epin

Question 37

what enzyme converts norepinephrine to epin and what stimulates this

Answer 37

PNMT and cortisol stimulates this

Question 38

___ stimulates the synthesis of DOPA

Answer 38

ACTH

Question 39

steps of norep and epin synthesis and locations

Answer 39

1) tyrosine to DOPA to Dopamine in the cytosol 2) Dopamine enters chromaffin granule through VMAT-1 3) Dopamine Beta hydroxylase converts to NE in granule 4) NE leaves granule through VMAT1 and is converted to epin by PNMT in cytosol 5) epin back into granule through VMAT1 and stored in complex

Question 40

the storage complex in the chromaffin granule contains what

Answer 40

ATP, Ca2+, NE, Epi, inside a chromogranin

Question 41

what is the RL step in NE and E synthesis

Answer 41

hydroxylation of tyrosine by tyrosine hydroxylase to produce DOPA Tyrosine ---tyrosine hydroxylase---> DOPA

Question 42

what are chromogranins and what can they be used to mark

Answer 42

complexes that decrease osmotic burden of storing individual molecules of E within chromaffin granules -can be marker of sympathetic paraganglion-derived tumors (paragangliomas)

Question 43

what can be measured to determine total catecholamine production

Answer 43

VMA

Question 44

epinephrine is degraded by _____ (enzyme) and turned into ___

Answer 44

COMT, metanephrine

Question 45

norepinephrine is degraded by ____ (enzyme) and turns to ___

Answer 45

COMT, normetanephrine

Question 46

normetanephrine and metanephrine are converted to ___ by what enzyme

Answer 46

VMA by MAO

Question 47

which receptors respond better to NE than E

Answer 47

a1,a2 and B3

Question 48

which receptors respond equal to NE and E

Answer 48

B1

Question 49

which receptors respond better to E than E

Answer 49

B2

Question 50

what are the 3 main symptoms of pheochromocytoma

Answer 50

headaches, sweating, palpitations

Question 51

what is a pehochromocytoma

Answer 51

tumor of chromaffin tissue

Question 52

short term stress stimulates adrenal medulla via what

Answer 52

preganlionic sympathetic fibers (catechole released)

Question 53

prolonged stress response from what

Answer 53

ACTH from AP

Question 54

17a hydroxylase deficiency leads to what presentation

Answer 54

male: ambiguous genitalia, undescended testes female: lacks secondary sexual development

Question 55

21 hydroxylase deficiency presentation

Answer 55

presents in infancy as salt wasting (hypotension), hypoglycemia childhood has precociouis puberty XX: virulization **most common CAH

Question 56

11 B hydroxylase defeciency effect on BP

Answer 56

decreases aldosterone but increaess 11-deoxycorticosterone which increases blood pressure

Question 57

11 B hydroxylase deficiency presentation

Answer 57

XX: virilization

Question 58

what is common presentation with all congenital adrenal hyperplasias

Answer 58

enlargement of both adrenal glands due to increaseased ACTH stimulation in response to low cortisol