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ENDO > Wk 9 > Flashcards

Wk 9 Flashcards

The Adrenal Cortex and Adrenal Medulla

1
Q

What are the two regions of the adrenal gland?

A
  1. Adrenal cortex - outer region
  2. Adrenal medulla - inner region
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2
Q

What are the three zones of the adrenal cortex?

A
  1. Zona glomerulosa (outer layer) - mineralocorticoids (salt)
  2. Zona fasciculata (middle layer) - glucocorticoids (sweet)
  3. Zona reticularis (inner layer) - androgens (sexy)
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3
Q

What are the 2 major types of steroid hormones secreted?

A

C19 and C21

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4
Q

What are the types of mineralocorticoids (salt) hormones?

A
  • Aldosterone
  • Deoxycorticosterone
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5
Q

What are the types of glucocorticoids (sweet) hormones?

A
  • Cortisol
  • Corticosterone
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6
Q

What are the types of androgen (sexy) hormones?

A
  • DHEA
  • Androstenedione
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7
Q

Which zone converts corticosterone to aldosterone?

A

Zona glomerulosa (only zone that contains aldosterone synthase).

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8
Q

What is the precursor of adrenal steroid hormones?

A

Cholesterol

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9
Q

What is biosynthesis pathway for zona glomerulosa?

A

Cholesterol –> Pregnenolone –> Progesterone –> Aldosterone

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10
Q

What is biosynthesis pathway for zona fasciculata?

A

Cholesterol –> Pregnenolone –> Progesterone –> Cortisol

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11
Q

What is biosynthesis pathway for zona reticularis?

A

Cholesterol –> Pregnenolone –> 17(OH) Pregnenolone –> Androstenedione

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12
Q

Where does cortisol act on primarily?

A
  • Liver
  • Skeletal muscle
  • Adipose tissue
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13
Q

What are the effects of cortisol on carbohydrate metabolism?

A
  • hyperglycemic hormone
  • increases blood glucose via stimulating gluconeogenesis (liver)
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14
Q

What are the effects of cortisol on protein metabolism?

A
  • increases proteins in liver ONLY
  • reduces protein stores in rest of body
  • increases blood AA
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15
Q

What are the effects of cortisol on fat metabolism?

A
  • increases lipolysis (fat breakdown)
  • utilises glycerol & fatty acids from lipolysis and redistributes when there is excess
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16
Q

How is cortisol transported in the blood?

A

Corticosteroid-binding globulin (CBG)

17
Q

What triggers the secretion of cortisol?

A

All forms of stress:
- trauma
- infection
- illness
- temperature change
- mental stress

18
Q

How is cortisol regulated?

A

Hypothalamic-pituitary-adrenal axis
CRH - hypothalamus
ACTH - pituitary

*negative feedback loop

19
Q

What is the effect of aldosterone in the kidney?

A

Regulation of electrolyte (mineral) conc. in extracellular fluids, especially conc. of sodium and potassium.

20
Q

What are the regulators of aldosterone secretion?

A
  1. Renin-angiotensin system (angiotensin II stimulates)
  2. Potassium (increase = stimulates)
  3. Sodium (increase = inhibits)
  4. ACTH (increase = stimulates)
  5. Atrial Natriuretic Peptide (ANP) (blocks/inhibits secretion)
21
Q

What is the adrenal medulla structure?

A

Modified sympathetic ganglion (preganglionic –> gland)
*Contains chromaffin

22
Q

What are the three catecholamines secreted from the adrenal medulla?

A
  1. Epinephrine
  2. Norepinephrine
  3. Dopamine
23
Q

What are catecholamines synthesised from?

A

Amino acid tyrosine

24
Q

What are the actions of the catecholamines secreted on the cardiovascular system?

A
  • increase cardiac output
  • increase venous return (blood flow into heart)
25
Q

What are the actions of the catecholamines secreted on blood glucose?

A
  • increase blood flow to skeletal muscle
  • increase blood glucagon/insulin ratio (alpha increase glucagon, beta decrease insulin)
  • increase glycogenolysis (breakdown of glycogen)
  • increase gluconeogenesis (formation of glucose from non-carbohydrates)
26
Q

What is the name of the syndrome with hypercortisolism?

A

Cushing’s syndrome

27
Q

What are the types of Cushing’s syndrome?

A
  1. Pituitary
  2. Adrenal
  3. Ectopic
28
Q

What is Pituitary Cushing’s Syndrome?

A
  • Pituitary adenoma
  • Elevated ACTH levels
29
Q

What is Adrenal Cushing’s Syndrome?

A
  • Disease in one/both adrenal glands
  • Low ACTH levels
30
Q

What is Ectopic Cushing’s Syndrome?

A
  • ACTH secretion from anywhere other than the anterior pituitary
  • Increased plasma ACTH
31
Q

What are symptoms of Cushing’s Disease?

A
  • red/moon face
  • central/truncal obesity
  • buffalo hump (shoulder)
32
Q

What are the signs of Addison’s Disease?

A
  • primary adrenal insufficiency
  • extremely low mineralocorticoids and glucocorticoids
  • due to TB or autoimmune chronic destruction of gland
33
Q

What are the symptoms of Addison’s Disease?

A
  • hyperpigmentation
  • hyperkalemia (increase K+)
  • acidosis (increase blood acid)
34
Q

Why does Addison’s Disease cause hyperpigmentation?

A

Elevated levels of ACTH can compete for binding of MC1R in melanocytes.

35
Q

What is congenital adrenal hyperplasia?

A
  • deficiency of the enzyme 21-hydroxylase
  • impaired cortisol = increased ACTH
  • high ACTH = drive adrenal androgen production ( by zona reticularis)
36
Q

What is the dexamethasone suppression test?

A

Laboratory test used to confirm Cushing’s Syndrome.

*Used to differentiate Cushing’s Disease from Ectopic Cushing’s Syndrome.

ENDO (10 decks)

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