Adrenal

Question 1

Direct precursor for cortisol?

Answer 1

11-deoxycortisol

Question 2

Direct precursor for Aldosterone?

Answer 2

Corticosterone

Question 3

Direct precursor for Androstenedione?

Answer 3

Dehydroepiandrosterone

Question 4

Angiotensin II is required for which adrenocortical hormone?

Answer 4

Aldosterone

Question 5

ACTH is necessary for conversion of cholesterol into _______.

Answer 5

Pregnenolone (precursor to aldosterone, cortisol, and androstenedione

Question 6

17a-hydroxylase is necessary for formation of __________ and __________, and unnecessary for ________________.

Answer 6

Necessary for Cortisol and Androstenedione

Unnecessary for Aldosterone

Question 7

A deficiency in 3B-hydroxysteroid dehydrogenase will prevent the formation of ________________ and _______________ and _____________

Answer 7

Aldosteron and Cortisol and Androstenedione will not be formed

Question 8

Most cholesterol is created de novo.

T/F

Answer 8

False

Most cholesterol is bound to LDL

Question 9

All adrenocortical steroids are made from ________________.

Answer 9

Cholesterol

Question 10

What happens to cholesterol we don’t need right now?

Answer 10

It is esterified and stored in cytoplasmic vesicles until needed.

Question 11

Glucocorticoids stimulate glycogenesis.

T/F

Answer 11

F

They stimulate Gluconeogenesis

Question 12

Cortisol is what class of adrenocortical hormone?

Answer 12

Glucocorticoid

Question 13

Androstenedione is what class of adrenocortical hormone?

Answer 13

Androgen

Question 14

Aldosterone is what class of androcortical hormone?

Answer 14

Mineralcorticoid

Question 15

Glucocorticoids can suppress the thymus.

T/F

Answer 15

T

They suppress the immune system this way

Question 16

In a nutshell, glucocorticoids do what?

Answer 16

Tear things down so we can make and store as much glucose as possible.

Decrease immune system

Increase GFR (glomerular filtration rate)

Question 17

Prolonged increase of GC often leads to

Answer 17

Diabetes Mellitus

Question 18

Dopamine, epinephrine, and norepinephrine are

Answer 18

Catacholamines

Question 19

Why are GC’s essential for survival during fasting?

Answer 19

They stimulate GNG

Question 20

Which of the following effects of cortisol DOES interfere with the body’s inflammatory response?

A. Induce synthesis of lipocortin
B. Inhibit the production of interleukin 2
C. Inhibit the release of histamine
D. Block the release of epinephrine

Answer 20

A, B, and C all interfere with inflammation.

Blocking epinephrine does not interfere.

Question 21

Name 2 drugs that inhibit GC

Answer 21

Metyrapone

• Inhibits 11B-hydroxylase (prevents Aldosterone and Cortisol formation)
• used in diagnosis of adrenal insufficiency

    Ketoconazole -Inhibits cholesterol desmolase (the first enzyme converting cholesterol into all 3 hormone classes)

Question 22

A patient with elevated levels of cortisol undergoes a dexamethasone suppression test. The high dose suppresses cortisol. What can be concluded?

Answer 22

The hypercortisolism is likely due to an anterior pituitary ACTH secreting tumor

Question 23

A patient with elevated levels of cortisol undergoes a dexamethasone suppression test. The high dose does not suppress cortisol. What can be concluded?

Answer 23

Adrenal cortex cortisol secreting tumor

Question 24

In a healthy person, a low dose of DXS will do what?

Answer 24

Decrease ACTH —-> Decrease cortisol

Question 25

What stimulates aldosterone synthase?

Answer 25

Angiotensin II

Question 26

Metyrapone will prevent the synthesis of what 2 hormones?

Answer 26

Aldosterone and cortisol by shutting down 11B-hydroxylase

Question 27

In renal cells, the enxyme 11B-hydroxysteroid dehydrogenase performs what function?

Answer 27

Converts cortisol to cortisone

Question 28

In a chromosomal XX female, masculinization is observed, including malformed external genitalia. Urinalysis shows an elevation of 17-ketosteroids. These findings are indicative of what?

Answer 28

21B-hydroxylase deficiency

Question 29

Cushing's SYNDROME vs Cushing's DISEASE

Answer 29

Syndrome: Chronic excess of GC due to overproduction of CORTISOL by ADRENAL CORTEX (or pharma overdose) Disease: Excess GC due to hypersecretion of ACTH for a PITUITARY ADENOMA. Same symptoms as the syndrome except ACTH is high.

Question 30

Shared symptoms of Cushing's Syndrome/Disease:

Answer 30

- Hyperglycemia - Proteolysis / muscle wasting - Decreased insulin sensitivity - Increased fat mobilization - perodoxical fat accumulation in face, shouders, and abdomen - moon face, buffalo hump, truncal obesity - Poor wound healing - Osteoporosis - Loss of CT = stretch marks / striae - Hypertension - Virilization and menstral disorders in females

Question 31

Conn's syndrome is Primary _______________

Answer 31

Hyperaldosteronism

Question 32

Conn's syndrome is caused by aldosterone secreting tumor T/F

Answer 32

Totally true.

Question 33

Spironolactone is used to treat what?

Answer 33

Conn's syndrome | It's an aldosterone antagonist.... Conn's is caused by an aldosterone secreting tumor

Question 34

What does this stuff: - inhibits renin release - increases ECF volume - increases Na and H2O Reabsorption causing hypertension - increases H+ excretion causing metabolic alkalosis

Answer 34

Conn's syndrome

Question 35

What issue does this patient have: - decreased androgens and GCs - increased mineralcorticoids - Hypertension - Hypokalemia - Metabolic alkalosis

Answer 35

17a-hydroxylase deficiency

Question 36

Your patient's name is Sarah-Beth Jane Jitzel Eisenhower. - Mrs. Eisenhower's adrenals do not produce mineralocorticoids or GCs - Mrs. Eisenhower shows increased production of adrenal androgens - She exhibits virilization and increased urinary levels or 17-ketosteroids. - Her ACTH levels are high - She shows adrenalcortical hyperplasia What does Mrs. Eisenhower have? How would we treat?

Answer 36

She has 21b-hydroxylase deficiency We would probably refer to someone who can prescribe replacement glucocorticoids and mineralocorticoids.

Question 37

In response to SNS stimulation, the adrenal medulla secretes mainly what substance into the blood?

Answer 37

Epinephrine