2-9-16-The Adrenal Gland (Lopez) Flashcards Preview

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Flashcards in 2-9-16-The Adrenal Gland (Lopez) Deck (55):
1

What types of hormones does the adrenal cortex secrete?

What types of hormones does the adrenal medulla secrete?

Steroids--> aldosterone, cortisol, androgens

AA derived --> epinephrine and norepinephrine

2

What are the 3 zones of the adrenal cortex from outer to inner layer?

Glomerulosa, fasciculata, reticularis

3

What does the zona glomerulosa secrete?

What does the zona fasciculata secrete?

What does the zona reticularis secrete?

Mineralocorticoids (aldosterone)

Glucocorticoids (cortisol) and androgens

Glucocorticoids (cortisol) and androgens

4

What does the adrenal medulla secrete?

Catecholamines (Epi and norepi)

5

___ is a transport protein that regulates cholesterol transfer within the mitochondria, which is the rate-limiting step in the production of steroid hormones

StAR (Steroidogenic Acute Regulatory Protein)

6

__ stimulates synthesis and secretion of adrenal cortical hormones such as glucocorticoids (cortisol) and mineralocorticoids (aldosterone)

ACTH

7

ACTH is a peptide hormone produced in the anterior pituitary and is derived from post-translational processing of ___

POMC (pro-opiomelanocortin)

8

The HPA axis is under negative feedback control by ___

Cortisol

9

List the effect of cortisol secretion on the following:

A-Immune system
B-Liver
C-Muscle
D-Adipose tissue

A-Immune suppression
B-Gluconeogenesis
C-Protein catabolism
D-Lipolysis

10

The secretory rates of cortisol are highest during ___ and lowest in the ___

Early morning

Late evening

11

Cushing's disease is caused by a pituitary tumor or an adrenal tumor and is an example of ____-cortisolism

Hyper-

12

Addison's disease can be caused by autoimmune disease of the adrenal gland and is an example of ____-cortisolism

Hypo-

13

Secondary adrenal insufficiency can be caused by glucocorticoid drugs suppressing the hypothalamus and Pituitary and is an example of ___-cortisolism

Hypo

14

Rounding of the face, excess fat on the back of the neck, excess weight gain in abdomen, and dark red or purple stretch marks are symptoms of ___

Cushing's syndrome

15

Primary hypercortisolism (Cushing's syndrome) is due to what?

Adrenal tumor that autonomously secretes cortisol (adrenal excess)

16

Secondary hypercortisolism (Cushing's disease) is due to what?

Pituitary tumor that autonomously secretes ACTH (pituitary excess)

17

A pituitary tumor that autonomously secretes ACTH is known as ____

Cushing's DISEASE --> secondary hypercortisolism, pituitary excess

18

Describe primary adrenocortical insufficiency

Addison's disease --> hyposecretion of all adrenal steroid hormones (hypocortisolism)

19

Describe secondary adrenocortical insufficiency

ACTH deficiency--> chronic exogenous glucocorticoid treatment (hypocortisolism)

20

Describe the levels of the following in Primary (adrenal) excess:
Plasma cortisol-
Plasma CRH-
Plasma ACTH-
Hyperpigmentation-

Plasma cortisol=increase
Plasma CRH=decrease
Plasma ACTH=decrease
Hyperpigmentation=no

21

Describe the levels of the following in Secondary (pituitary) excess:
Plasma cortisol-
Plasma CRH-
Plasma ACTH-
Hyperpigmentation-

Plasma cortisol=increase
Plasma CRH=decrease
Plasma ACTH=increase
Hyperpigmentation=Yes

22

Describe the levels of the following in Primary cortisol deficiency:
Plasma cortisol-
Plasma CRH-
Plasma ACTH-
Hyperpigmentation-

Plasma cortisol=decrease
Plasma CRH=increase
Plasma ACTH=increase
Hyperpigmentation=Yes

23

Describe the levels of the following in Secondary cortisol deficiency:
Plasma cortisol-
Plasma CRH-
Plasma ACTH-
Hyperpigmentation-

Plasma cortisol=decrease
Plasma CRH=increase
Plasma ACTH=decrease
Hyperpigmentation=No

24

Describe the levels of the following after steroid administration (synthetics other than cortisol)
Plasma cortisol-
Plasma CRH-
Plasma ACTH-
Hyperpigmentation-

Plasma cortisol=decrease (but symptoms of excess)
Plasma CRH=decrease
Plasma ACTH=decrease
Hyperpigmentation=no

25

___ test can be used to detect adrenal gland insufficiency

Cosyntropin (synthetic ACTH) stimulation test

26

The primary action of aldosterone is ___

Renal sodium reabsorption

27

List the steps that result in increased Na reabsorption and K secretion due to the action of aldosterone in the DCT

1) aldosterone combines with a cytoplasmic receptor --> 2) hormone-receptor complex initiates transcription in the nucleus --> 3) translation and protein synthesis makes new protein channels and pumps --> 4) aldosterone-induced proteins modulate existing channels and pumps --> 5) result is increase Na reabsorption and K secretion

28

___ is characterized by excessive release of aldosterone from the adrenal cortex

Primary hyperaldosteronism

29

__ is due to an adenoma in the adrenal cortex

Conn's syndrome

30

___ is due to excessive renin secretion by the juxtaglomerular cells in the kidney

Secondary hyperaldosteronism

31

___ is due to destruction of the adrenal cortex and leads to defects in aldosterone synthesis and inadequate stimulation of aldosterone secretion

Hypoaldosteronism

32

What is a possible treatment for Addison's disease?

Steroid replacement therapy for life

33

What is a likely treatment for Conn's dyndrome (adrenal adosteronoma)?

Surgery

34

WHat is a likely treatment option for bilateral adrenal hyperplasia?

Spironolactone (K-sparing diuretics)

35

___ responds to stress such as hypoglycemia/exercise and influences energy metabolism and cardiac output

Epinephrine

36

What is the initial substrate (amino acid) in the formation of norepi and epi?

Tyrosin

37

In order for tyrosine hydroxylase to convert Tyrosine to DOPA, what else needs to happen?

Sympathetic stimulation with Ach

38

In order for Dopamine to be converted to Norepinephrine via dopamine-beta-hydroxylase, what needs to happen?

Sympathetic stimulation via Ach

39

The synthesis of catecholamines is under the control of the __ axis

CRH-ACTH-Cortisol axis

40

___ stimulates synthesis of DOPA

___ increases PNMT enzyme

ACTH

Cortisol

41

This enzyme catalyzes the formation of epinephrine from norepinephrine

PNMT plus cortisol

42

Where is Epi synthesized?

In the cytosol from NE

43

What is the rate-limiting step in the formation of catecholamines?

Tyrosine hydroxylase catalyzing TYROSINE --> DOPA

44

DOPA is converted to DOPAMINE by the cytoplasmic enzyme ___ and is then transported into this secretory vesicle ___

Aromatic Amino Acid Decarboxylase

Chromaffin granule

45

Within the chromaffin granule, dopamine is converted to NE by the enzyme ___

Dopamine-beta-hydroxylase

46

Epinephrine gets transported back into the chromaffin granule by ___

Vesicular monoamine transporters (VMAT)

47

___ are multimolecular complexes, thought to decrease the osmotic burden of storing individual molecules of epinephrine within chromaffin granules.

Chromogranins

48

Circulating ___ can be used as a marker of sympathetic paraganglion-derived tumors (paragangliomas)

Chromogranins

49

Epinephrine --> dihydroxymandelic acid

MAO

50

Epi --> metanephrine is catalyzed by ____

NE --> normetanephrine is catalyzed by ___

COMT

COMT

51

Metanehprine --> Vanillylmandelic acid (in urine)

MAO

52

The adrenal medulla is of ___ origin

The adrenal cortex is of ___ origin

Ectodermal

Epidermal

53

___ receptor(s) respond better to norepi than epi

___ receptor(s) respond equally to norepi and epi

Epi is more potent than norepi for the ___ receptor(s)

Alpha and beta3

Beta1

Beta2

54

List which adrenergic receptor types result with an increase in cAMP

List which adrenergic receptor types result with a decrease in cAMP

List which adrenergic receptor types result in an increase in IP3 and Ca, and DAG

Beta1/2/3

Alpha2

Alpha1

55

___ is a tumor of chromaffin tissue and results in an excess production of catecholamines. Symptoms include hypertension, orthostatic hypotension, headaches, sweating, anxiety, palpitations, chest pain, and flushing

Pheochromocytoma