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MD1 Endocrine > Adrenocortical Function and Dysfunction > Flashcards

Adrenocortical Function and Dysfunction Flashcards

1
Q

Where are the adrenal glands located?

A

Sit on top of kidneys

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2
Q

Do the adrenal cortex and medulla have the same embryological origin?

A

No - 2 different glands

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3
Q

What type of gland is the adrenal medulla?

A

Modified sympathetic ganglion

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4
Q

What does the adrenal medulla secrete?

A

Catecholamines

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5
Q

What type of gland is the adrenal cortex?

A

True endocrine gland

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6
Q

What does the adrenal cortex secrete?

A

Steroid hormones

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7
Q

What does the zona reticularis secrete?

A

Sex steroids

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8
Q

What does the zona fasciculata secrete?

A

Glucocorticoids

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9
Q

What does the zona glomerulosa secrete?

A

Aldosterone

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10
Q

Are sex hormones also produced by the zona fasciculata?

A

Yes, a little bit

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11
Q

Are glucocorticoids also produced by the zona reticularis?

A

Yes, a little bit

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12
Q

What stimulates the synthesis and release of cortisol?

A

Hypothalamic-pituitary-adrenal axis

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13
Q

What stimulates the synthesis and release of aldosterone?

A

RAAS

Plasma K

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14
Q

Why do different cells of the adrenal cortex produce different steroids?

A

Contain different enzymes

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15
Q

Why can you get crossover effects with steroid hormones?

A

Chemically related

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16
Q

Are steroid hormones stored or made on demand?

A

Made on demand

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17
Q

What are the major triggers for cortisol release?

A

Circadian rhythm

Stress

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18
Q

What is the effect of cortisol on the immune system?

A

Function suppressed

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19
Q

What is the effect of cortisol on the liver?

A

Gluconeogenesis

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20
Q

What is the effect of cortisol on the muscle?

A

Protein catabolism

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21
Q

What is the effect of cortisol on adipose tissue?

A

Lipolysis

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22
Q

What are the other functions of CRH and ACTH?

A

Some stress-related functions in immune and nervous systems

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23
Q

What is urocortin?

A

Peptide related to CRH

Brain neuropeptide decreases appetite

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24
Q

What is pro-opiomelanocortin (POMC)?

A

Large protein

Yields several bioactive peptide by proteolysis

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25
Q

What peptides are produced from POMC by the anterior pituitary?

A

ACTH

Beta-endorphin

26
Q

What does beta-endorphin do?

A

Block pain perception

27
Q

What peptide is produced from POMC outside the pituitary?

A

Alpha-MSH

28
Q

What is alpha-MSH?

A

Melanocyte stimuating hormone
Decreases food intake
Increases skin melanin

29
Q

What are melanocortins?

A

Family name for MSH hormones and ACTH

30
Q

Is cortisol essential for life?

A

Yes

31
Q

What does cortisol do?

A

Helps body cope with long-term stress
Protects against hypoglycaemia
- Stimulates catabolism of energy stores
Permissive for glucagon and catecholamine actions

32
Q

When is cortisol released?

A

Diurnal rhythm

  • Peaks morning
  • Low night
33
Q

What is the effect of cortisol on calcium balance?

A

Negative Ca balance

  • Decreased absorption
  • Increased excretion
  • Increased bone breakdown
34
Q

What are the therapeutic uses of cortisol?

A

Bee stings, poison ivy, pollen allergies

Prevents rejection of transplanted organs

35
Q

What does long-term use of cortisol result in?

A

Inhibition of ACTH (and its related peptides) secretion

Atrophy of cortisol-secreting cells

36
Q

What is the half life of cortisol?

A

60-90 min

37
Q

What are the target tissues of cortisol?

A

Most

38
Q

Where is the target receptor of cortisol located?

A

Intracellular

39
Q

What does hyperaldosteronism cause?

A

Hypernatremia
Hypokalemia
Hypertension

40
Q

What is primary hyperaldosteronism called?

A

Conn’s syndrome

41
Q

What is Cushing’s syndrome?

A

Excess cortisol

42
Q

What causes primary hypercortisolism?

A

Adrenal cortex tumours autonomously secrete cortisol

43
Q

What is Cushing’s disease?

A

Secondary cause of hypercortisolism

Pituitary tumour autonomously secretes ACTH

44
Q

What are the possible causes of Cushing’s syndrome?

A

Primary
Secondary
Hyperstimulation by CRH/ACTH
Iatrogenic

45
Q

What is adrenogenital syndrome?

A

Excess androgen and oestrogen

46
Q

What causes adrenogenital syndrome?

A

Lack enzyme in cortisol steroidogenic pathway

47
Q

What is the clinical presentation of adrenogenital syndrome?

A

Inappropriate masculinisation in all but adult males

48
Q

What is the treatment for adrenogenital syndrome?

A

Glucocorticoids

  • Repairs glucocorticoid deficit
  • Inhibit ACTH > reduce steroid secretion
49
Q

What are the symptoms of Cushing’s syndrome?

A

Excess gluconeogenesis > hyperglycaemia mimicking diabetes
Muscle protein breakdown and lipolysis > wasting
Increased appetite > paradoxical fat deposits in trunk and face
Thin arms and legs
Trunk obesity
Moon face
Stretched skin > reddish striae
Excess cortisol binds to mineralocorticoid receptors
- Salt and water retention
- Moon face
- Weakness
- Hypertension
Osteoporosis
Mood elevation then depression
Difficulty in learning and memory

50
Q

What is more common: adrenal hypersecretion or hyposecretion?

A

Hyposecretion

51
Q

What is Addison’s disease?

A

Primary adrenal insufficiency
Autoimmune destruction of adrenal cortex
Hyposecretion of all adrenal steroid hormones

52
Q

What does decreased aldosterone in Addison’s disease cause?

A

K retention > cardiac arrythmias

Na depletion > hypotension

53
Q

What does decreased cortisol in Addison’s disease cause?

A

Decreased stress respone

Hypoglycaemia

54
Q

What do hereditary adrenal steroid enzyme defects cause?

A

Lack of cortisol and aldosterone > increased androgens > adrenogenital syndrome

55
Q

What does a secondary hyposecretion of the adrenal cortex cause?

A

Decreased ACTH

Deficient cortisol only

56
Q

Which cells in the adrenal medulla secrete neurohormones?

A

Chromaffin cells

57
Q

What are the actions of adrenomedullary hormones?

A 
Flight or fight responses
- Increased cardiac rate and contractility
- Increased TPR
- Increased BP
Metabolic effects
- Increased glucose and FFAs
- Increased basal metabolic rate
Central effects
- Increased arousal and alertness
58
Q

Does hyposecretion of the adrenal medulla occur?

A

No

59
Q

What causes hypersecretion of the adrenal medulla?

A

Pheochromocytomas = tumour

60
Q

What type of response does acute stress result in?

A

Fight or flight

61
Q

What type of response does chronic stress result in?

A

Elevated cortisol levels

MD1 Endocrine (18 decks)

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