25.1

Question 1

The main adrenocortical hormones are ___ and ___.

Answer 1

Glucocorticoids e.g. cortisol

Mineralocorticoids e.g. aldosterone

Question 2

The main adrenomedullary hormones are ___ and ___.

Answer 2

Adrenaline and noradrenaline

Question 3

A disease causing excess cortisol is ___ disease, and a disease causing deficiency of cortisol is ___ disease.

Answer 3

Cushing’s – excess of cortisol.

Addison’s – deficiency of cortisol.

Question 4

Cortisol is the same as ___.

Answer 4

Hydrocortisone

Question 5

Cortisone (or cortisone acetate) is a ___ of cortisol.

Answer 5

Metabolite

Question 6

There are 3 pathways from cholesterol to produce ___, ___ or ___ hormones.

Answer 6

Aldosterone, cortisol or sex hormones (testosterone/estrogen)

Question 7

What are the actions of glucocorticoids?

Answer 7

Stimulation of gluconeogenesis (liver)
Mobilisation of amino acids (muscle)
Stimulation of lipolysis (adipose tissues)
Immunosuppresion

Question 8

What are the effects of excess cortisol?

Answer 8

Weight gain, wasting of muscle, skin and bone, hyperglycaemia, hypertension (salt retention), inhibition of linear growth (in childhood)

Question 9

Cushing’s disease refers to a pituitary ___ resulting in excess ACTH.

Answer 9

Adenoma

Question 10

What are the signs and symptoms of Cushing’s disease?

Answer 10

Hypertension, apparent obesity, muscle wasting, thin skin, metabolic derangements e.g. diabetes, moon facies (round face), obesity, menstrual disorders, hirsutism, weakness, red striae, bruisability, “lemon on toothpicks” body

Question 11

What are the effects of deficiency or low cortisol?

Answer 11

Non-specific symptoms!
Key one is darkening of skin
GI symptoms, low blood pressure, muscle weakness, increased susceptibility to infection, death

Question 12

What is darkening of skin a feature of cortisol deficiency?

Answer 12

If ACTH secretion is stimulated (because cortisol is low) -> stimulation of melanocytes!

Question 13

In Australia, Addison’s disease is usually due to ___ causes.

Answer 13

Autoimmune

Question 14

What is a common cause of excess adrenal androgens?

Answer 14

Congenital adrenal hyperplasia

Question 15

In congenital adrenal hyperplasia, there is deficiency of ___-____.

Answer 15

21-hydroxylase

Question 16

21-hydroxylase (deficient in congenital adrenal hyperplasia) is involved in the formation of ___ and ___. Therefore, there is an increase in ACTH and an increase in ___.

Answer 16

Formation of cortisol and aldosterone
Deficiency leads to a decrease in cortisol and aldosterone production
And an increase in androgens!

Question 17

Cortisone is biologically inactive but is converted to ___ (active) in the ___.

Answer 17

Cortisol in the liver

Question 18

What are the actions of mineralocorticoids?

Answer 18

Aldosterone regulates [Na+] and [K+] in ECF
It causes increased resorption of [Na+] (and water with sodium), and increased excretion of K+ from distal tubule of kidney

Question 19

K+ and angiotensin II regulate ___ secretion.

Answer 19

Aldosterone

Question 20

What is a cause of excess aldosterone?

Answer 20

Conn’s syndrome

Question 21

What are the symptoms of Conn’s syndrome?

Answer 21

Conn’s syndrome is an excess of aldosterone due to an adrenal tumour
There is hypertension (due to salt retention) and muscle weakness (due to hypokalaemia)

Question 22

If there is a deficiency of aldosterone, what are the effects?

Answer 22

Dehydration, salt depletion and postural hypotension

Cardiac arrhythmia due to hyperkalaemia