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Flashcards in Adrenal Androgens Deck (59):
1

Where are adrenal androgens produced?

Zona reticularis of the adrenal cortex

2

What three adrenal androgens are released from the zona reticularis?

Dehydroepiandrosterone (DHEA)
Androstenedione
Testosterone

3

What receptor takes in cholesterol for steroid hormone production?

SRB1 (scavenger receptor class B member 1)

4

What binds to SRB1?

LDL
HDL

5

What regulates the synthesis of adrenal androgens?

ACTH
CASH (cortical androgen stimulating hormone)

6

What binds and carries androgens in the blood?

SHBG (sex hormone binding globulin)

7

What has a negative feedback on ACTH?

Only cortisol not any other steroid hormone

8

What receptor does ACTH bind to in the adrenal cortex?

MC2R (melanocortin-2 receptor)

9

What does cortisol inhibit?

CRH from hypothalamus
ACTH and CASH from anterior pituitary

10

What are two different forms of DHEA?

DHEA
DHEAS (sulfate)

11

Which DHEA has a longer half-life?

DHEAS

12

Where is testosterone mostly created?

Leydig cells in the testes (95%)
Only 5% created in the zona reticularis

13

How is testosterone carried in the blood?

98% binds to albumin and SHBG

14

What are the most abundant steroid hormones in the bloodstream?

DHEA
DHEAS

15

What is adrenarche?

Period in time (10-11 years of age) in which the zona reticularis is developed and begins to create androgens in an increased level without increased cortisol

16

When does adrenarche occur?

Age of puberty 10-11 years old

17

Where does DHEA go in premenopausal females?

Ovary for estradiol (E2) and testosterone formation
Mammary gland

18

Where does DHEA go in males?

Testes for testosterone production
Prostate

19

What does 11B-HSD2 do?

Converts cortisol to cortisone

20

Free androgens (DHT/Estradiol) are highly metabolized where in the body?

Liver and excreted by the kidney

21

What are the metabolites of DHT and Estradiol?

Androsterone
Etiocholanolone

22

Effects of DHEA?

Pubertal growth spurt (essentially everything involved in growing)

23

Effect of estrogen on bones?

Epiphysis fusion of bones and mineralization

24

Effect of DHEA on immune system?

Antagonizes cortisol

25

What is the effect of DHEA on endothelial function?

Increases eNOS -> NO production causing vasodilation

26

What does 5alpha-reductase do?

Converts testosterone to DHT

27

What does aromatase do?

Converts testosterone to estradiol

28

What does a deficiency in aromatase or estrogen receptor cause?

Failure to fuse long bones
Osteoporosis

29

What develops from the Wolffian mesonephric duct?

Epididymis
Vas deferens
Seminal vesicle
Ejaculatory duct

30

What develops from the Mullerian paramesonephric duct?

Fallopian tubes
Uterus
Upper part of vagina

31

What genes on the Y chromosome determines the sex of the fetus?

SRY gene

32

SRY gene in gonads causes formation of Sertoli cells, what do the Sertoli cells release?

Mullerian inhibiting substance (MIS)

33

What does MIS cause?

Mullerian duct degeneration

34

SRY gene in gonads causes formation of Leydig cells, what do the Leydig cells release and the effect?

Testosterone
Causes Wolffian duct development

35

What medical problem in women has the highest negative impact on morbidity?

Menopause

36

What occurs to sodium and potassium levels in 21-alpha hydroxylase deficiency?

Hyponatremia
Hyperkalemia

37

Why do you have Hyponatremia and hyperkalemia in 21-alpha hydroxylase deficiency?

Decreased aldosterone not

38

What does a 21-alpha hydroxylase deficiency cause in steroid hormone production?

Cannot produce mineralocorticoids or glucocorticoids so it is shunted to formation of androgens

39

Most common congenital genetic enzymatic defect in steroid hormone synthesis?

21-hydroxylase (same as 21-alpha hydroxylase)

40

Second most common congenital genetic enzymatic defect in steroid hormone synthesis?

11-beta hydroxylase

41

What occurs in 21 alpha-hydroxylase deficiency?

ACTH loss of negative feedback
Increased androgen shunting
Virilization

42

What is Virilization?

Presence of masculine traits

43

What occurs in 11 beta-hydroxylase defects?

Increase in deoxycortisol/deoxycorticocosterone
Decrease but not loss of cortisol negative feedback
Increased androgen shunting/Virilization
Salt and water retention (hypertension)

44

Why do you still have mild ACTH negative feedback and hypertension in 11 beta-hydroxylase defects but not 21 alpha-hydroxylase defects?

Because in 11 beta-hydroxylase you have a build up of the intermediates (deoxycortisol/deoxycorticocosterone) that have mild effects on ACTH and large effects on ENaC (increased Na retention)

45

Effects of 17 alpha-hydroxylase deficiency?

Increase in mineralocorticoids and aldosterone

46

What is androgen insensitivity syndrome?

Mutation in androgen receptor such that tissues do not respond to testosterone or other androgens

47

What gonads develop in androgen insensitivity syndrome?

The testes

48

What do individuals develop as externally with androgen insensitivity syndrome?

Female (they are XY males though)

49

How is androgen insensitivity syndrome detected?

Amenorrhea (lack of menstruation)

50

Proper development of what is dependent on DHT?

Penis
Prostate gland

51

What occurs in 5-alpha reductase type 2 disorder?

Males are born with female-appearing external genitalia
Hypospadias (penis doesn't enlarge)

52

What occurs at puberty in 5 alpha-reductase disorder?

Large levels of circulating testosterone stimulate development of male structures

53

What does the drug Abiraterone do?

Inhibits both 17,20-lyase and 17 alpha-hydroxylase

54

What does Abiraterone administration result in?

Inhibition of androgen and glucocorticoid synthesis and shunting to mineralocorticoid synthesis

55

What gene does CYP17A1 code for?

17,20-lyase and 17 alpha-hydroxylase

56

When is Abiraterone administered?

Prostate hyperplasia
Prostate cancer

57

What is given with Abiraterone to counteract the effects of decreased glucocorticoids?

Prednisone

58

What is Kennedy's disease?

X-linked bulbospinal neuropathy

59

What occurs in Kennedy's disease?

Androgen receptor mutation