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MEH > The Adrenal Glands > Flashcards

The Adrenal Glands Flashcards

1
Q

Parts of the adrenal gland and what they secrete

A

Zona glomerulosa - mineralocorticoids
Zona fasiculata - glucocorticoids
Zona reticularis - glucocorticoids and small amount of androgens
Chromaffin cells - adrenaline, noradrenaline

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2
Q

Two types of androgens

A

Dehydroepiandrosterone

Androstenedione

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3
Q

How do corticosteroids exert their actions?

A
  • Readily diffuse across plasma membrane
  • Bind to glucocorticoid receptor
  • Binding causes dissociation of chaperone proteins
  • Receptor ligand complex translocates to nucleus
  • Dimerisation with other receptors can occur
  • Receptors bind to glucocorticoid response elements (GREs) or other transcription factors
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4
Q

Carrier protein of aldosterone

A

Serum albumin, and to a lesser extent transcortin

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5
Q

What does aldosterone play a central role in?

A

Regulation of plasma Na+, K+ and arterial blood pressure. Promotes expression of Na+/K+ pump, promoting reabsorption of Na+ and excretion of K+

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6
Q

The RAAS

A

Angiotensinogen > (renin) > Angiotensin I > (ACE) > Angiotensin II > ADH, Aldosterone, vasoconstriction

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7
Q

What effect does ADH have on water reabsorption?

A

Translocation of aquaporin channels aids reabsorption of water back into the blood

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8
Q

Primary hyperaldosteronism

A

Defect in adrenal cortex:

  • Bilateral idiopathic adrenal hyperplasia
  • Aldosterone secreting adrenal adenoma (Conn’s syndrome)
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9
Q

Secondary hyperaldosteronism

A

Due to over activity of the RAAS:

  • Renin producing tumour e.g. juxtaglomerular tumour
  • Renal artery stenosis
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10
Q

Best way to distinguish between primary and secondary hyperaldosteronism

A

Primary - low renin

Secondary - high renin

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11
Q

Signs of hyperaldosteronism

A
  • High blood pressure
  • Left ventricular hypertrophy
  • Stroke
  • Hypernatraemia
  • Hypokalaemia
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12
Q

Treatment for hyperaldosteronism

A
  • Aldosterone producing adenomas removed by surgery

- Spironolactone (mineralocorticoid receptor antagonist)

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13
Q

Carrier protein of cortisol

A

Transcortin

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14
Q

Actions of cortisol

A
  • Increased protein breakdown in muscles
  • Increased gluconeogenesis in liver
  • Increased lipolysis in fat
  • Resistance to stress (increased supply of glucose, raise blood pressure by making vessels more sensitive to vasoconstrictors)
  • Anti inflammatory effects (inhibits macrophage activity and mast cell degranulation)
  • Depression of immune response
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15
Q

Symptoms of Cushings

A
  • Plethoric moon shaped face
  • Buffalo hump
  • Abdonimal obesity
  • Purple striae
  • Acute weight gain
  • Hyperglycaemia
  • Hypertension
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16
Q

Symptoms of Addison’s

A
  • Postural hypotension
  • Lethargy
  • Weight loss
  • Anorexia
  • Increased skin pigmentation
  • Hypoglycaemia
17
Q

Most common cause of Addison’s

A

Destructive atrophy from autoimmune response

18
Q

Hyperpigmentation in Addisons

A

Negative feedback on anterior pituitary reduced so more POMC to synthesise ACTH. ACTH itself activated melanocortin receptors on melanocytes. MSH stimulates melanin production

19
Q

Addison’s crisis precipitated by:

A
  • Severe stress
  • Salt deprivation
  • Infection
  • Trauma
  • Cold exposure
  • Over exertion
  • Abrupt steroid drug withdrawal
20
Q

Addison’s symptoms

A
  • Nausea
  • Vomiting
  • Pyrexia
  • Hypotension
  • Vascular collapse
21
Q

Addison’s treatment

A
  • Fluid replacement

- Cortisol

22
Q

Which enzyme is needed to convert noradrenaline to adrenaline?

A

N-methyl transferase

23
Q

G protein coupled receptor alpha 1 pathway

A

+ve Phospholipase C > Diacylglycerol and IP3 > PKC and Ca2+ release via IP3 receptor

24
Q

G protein coupled receptor alpha 2 pathway

A

-ve Adenylyl cyclase > cAMP > Protein kinase A

25
Q

G protein coupled receptor beta 1 and 2 pathway

A

+ve Adenylyl cyclase > cAMP > Protein kinase A

26
Q

Phaeochromocytoma characteristics

A
  • Severe hypertension
  • Headaches
  • Palpitations
  • Diaphoresis
  • Anxiety
  • Weight loss
  • Elevated blood glucose
27
Q

Cortisol deficiency symptoms

A
  • Weakness
  • Tiredness
  • Weight loss
  • Hypoglycaemia
28
Q

Mineralcorticoid deficiency symptoms

A
  • Dizziness
  • Low Na
  • High K
29
Q

Androgen deficiency symptoms

A
  • Low libido

- Loss of body hair in women

MEH (12 decks)

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