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Physiology Exam 2 > Endo 4 > Flashcards

Endo 4 Flashcards

1
Q

Where are the adrenal glands ?

A

superior to each kidney

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2
Q

What does the adrenal cortex secrete?

A

-corticosteroids
-mineralcorticoids
-sex hormones

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3
Q

What is the adrenal medulla?

A

20-30% of the gland
-secrete epinephrine and norepinephrine in response to SNS stimulation
-these hormones are not essential to life but help the individual to deal with emergencies

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4
Q

What type of hormones are the adrenal cortex hormones?

A

steroids
-all derived from cholesterol

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5
Q

What are the three layers of the adrenal cortex?

A

-zona glomerulosa
-zona fasculata
-zona reticualris

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6
Q

What hormones are made in the zona glomerulosa?

A

mineralcorticoids
-aldosterone
(renin-angiotensin-aldosterone system)

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7
Q

What hormones are made in the zona fasciculata?

A

glucocorticoids
-cortisol
(hypothalamic-pituitary-adrenal axis)

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8
Q

What hormones are made in the zona reticularis?

A

androgens
-DHEA
(hypothalamic-pituitary-adrenal axis)

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9
Q

What hormones are made by the adrenal medulla?

A

catecholamines

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10
Q

What is the effect of aldosterone?

A

increase renal tubular reabsorption of Na and secretion of K
-lead to an increase in EC fluid volume and mean arterial pressure

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11
Q

What stimulates the secretion of aldosterone??

A

angiotension II
high K
low Na

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12
Q

What does aldosterone do to blood pressure?

A

increase

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13
Q

What does aldosterone do to sweat and salivary glands?

A

increase reabsorption of sodium and secretion of potassium by gland ducts
-help to conserve body salt in hot environments
-help to conserve sodium during times of high salivary secretions

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14
Q

What is renin?

A

enzyme released by the cells in the kidney in response to a variety of stimuli

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15
Q

what makes ACE?

A

endothelium cells
_lungs make a lot

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16
Q

What turns angiotensinogen into angiotensin I

A

renin

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17
Q

What turns angiotensin 1 into angiotensin 2?

A

ACE

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18
Q

What does angiotensin 2 do?

A

-vasoconstriction
-ADH secretion
-thirst stimulation
-aldosterone secretion

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18
Q

What are the steps that lead to aldosterone secretion?

A

-angiotensinogen
-angiotensin 1
-angiotensin 2
-aldosterone

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18
Q

What is the name of primary hyperaldosteronism?

A

Conn’s syndrome

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19
Q

What are the signs and symptoms of primary hyperaldosteronism?

A

hypertension, hyperatremia, headaches, potassium depletion, weakness, fatigue, polyuria, hypokalemic alkalosis, and low plasma renin

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19
Q

What causes primary hyperaldosteronism?

A

adrenal adenoma, adrenal hyperplasia, and adrenal carcinoma

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20
Q

What are the treatment options for primary hyperaldosteronism?

A

-surgical removal of the tumor or most od the adrenal tissue where hyperplasia has occurred
-pharmacological antagonism of the mineralcorticoid receptor

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21
Q

What is secondary hyperaldosteronism?

A

increase in aldosterone secretion that is not the adrenal gland’s fault
-caused by decreased blood flow and pressure and renal artery

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22
Q

What can cause secondary hyperaldosteronism?

A

-CHF
-cirrhosis
-nephrosis
-renal artery stenosis (kidneys think the blood pressure is low, so they will cause increased secretion of aldosterone to try and increase the blood pressure)

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23
Q

What are the signs and symptoms of secondary hyperaldosteronism?

A

-high plasma renin activity
-hyperatremia with extracellular volume expansion
-edema
-decreased cardiac output

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24
Q

What is cortisol?

A

the stress hormone

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25
Q

What are the types of stress that will increase the release of cortisol?

A

-trauma of almost any type
-intense heat or cold
-infection
-injection of norepinephrine
-surgery
-hypoglycemia
-physiological stress
-almost any debilitating disease

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26
Q

What is cortisol secretion the highest?

A

in the mornings

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27
Q

What is long negative feedback?

A

when the signal comes form the endocrine gland

28
Q

What does cortisol do?

A

-gluconeogenesis
-protein metabolism
-fat mobilization
-stabilize lysosomes

29
Q

Is ACTH the only thing secreted when it is?

A

no, ACTH is a part of a larger preprohormone

30
Q

What is the preprohormone of ACTH?

A

proopiomealoncortin

31
Q

What is another hormone secreted with ACTH?

A

MSH

32
Q

What does MSH do?

A

stimulates the formation of melanin pigment

33
Q

What can increases levels of MSH cause ?

A

extra pigmentation in certain areas of the skin (this is why addison’s disease is associated with hyperpigmentation)

34
Q

Even though cortisol is circulating in much higher rates than aldosterone, there is usually not signs of mineralcorticoid excess, why?

A

there are hormones that convert cortisol into cortisone, which is not able to bind to the receptors

35
Q

What does cortisol do to blood pressure?

A

increase

36
Q

How does black licorice cause hypertension?

A

black licorice has glycyrrhetininc acid which inhibits the enzyme that converts cortisol to cortisone
-this leads more cortisol circulating
-the cortisol leads to increase blood pressure

37
Q

What turns cortisol to cortisone?

A

11 beta HSD2

38
Q

What turns cortisone back to cortisol?

A

11 beta HSD1

39
Q

What does cortisol do to carbohydrate metabolism?

A

-stimulate increase of plasma glucose
-decrease glucose intake in muscles and fat: not the brain and heart
-make diabetes worse

40
Q

What does cortisol do to protein metabolism?

A

-inhibit protein synthesis and increase proteolysis
-lead to muscle weakness

41
Q

What does cortisol do to lipid metabolism?

A

promote lipolysis
-cause lipid deposition in certain areas

42
Q

What are the effects of low glucocorticoids”?

A

-circulatory failure due to loss of permissive action of catecholeamines on BV
-prevent mobilization of energy during stress and can lead to hyperglycemia

43
Q

What are the anti-inflammatory effects of cortisol on the immune system?

A

-stabilize lysosomal membrane
-decrease capillary membrane
-decrease WBC migration and phagocytosis
-suppress T lymphocytes proliferation
-decrease IL-1 secretion from WBC

44
Q

When does the zona reticularis start secret ing androgens?

A

around the age of 8 and start declining at the age of 20

45
Q

What are the zona reticularis hormones?

A

DHEA
androstenedione
testosterone

46
Q

What are the functions of adrenal androgens?

A

-weak effect in males
-50% of active androgens in females (growth of pubic and axillary hair and libido in females)

47
Q

What can excess adrenal androgens lead to?

A

-in pre-pubertal boys can lead to pseudopuberty

48
Q

What hormones does 21-hydroxylase help make?

A

androgens and cortisol

49
Q

What can a deficiency in 21-hydroxylase cause?

A

virilization in newborn females and pseudohermaphroditism

50
Q

What is androstenedione converted into?

A

testosterone and 5-dihydrotestosterone

51
Q

What are signs and symptoms of virilization?

A

-hirsutism
-male-pattern baldness
-acne
-deep voice
-male musculature
-irregular menses or amonorrhea
-clitomegaly
-increases libido

52
Q

What can cause virilization>

A

adrenal adeomas that lead to increase secretion of adrenal androgens
-ovarian tumors are a common cause of this in women

53
Q

What is primary adrenal insufficiency known as?

A

addisons

54
Q

What can cause addisons

A

primary atrophy or injury of adrenal cortex
(80% of the time, the atrophy is due to autoimmune destruction)

55
Q

Is ACTH high or low in addisons?

A

high, but low corticosteroid production

56
Q

What is secondary adrenal insufficiency?

A

pituitary gland is unable to secrete enough ACTH

57
Q

Is ACTH high or low in secondary adrenal insufficiency?

A

low, with low cortisol production as well

58
Q

What are the signs and symptoms of glucocorticoid deficiency? (primary and secondary)

A

-fatigue, lack of energy
-weight loss
-myalgia, joint pain
-fever
-normochromic anemia, lymphocytes, esosinophils
-slightly increase TSH
-hypoglycemia
-low blood pressure
-hypoatremia

59
Q

What are the signs and symptoms of mineralcorticoid deficiency? (primary only)

A

-abdominal pain, nausea, vomitting
-dizziness, postural hypotension
-salt craving
-low blood pressure
-increase serum creatinine
-hypoatremia
-hyperkalemia

60
Q

What are the signs and symptoms of adrenal androgen deficiency? (primary and maybe secondary)

A

-lack of energy
-dry and itchy skin
-loss of libido
-loss of axillary and pubic hair

61
Q

What are oral manifestations of addisons?

A

skin pigmentation
-mucocutaneous junctions in lips
-intraoral mucosal surfaces
-buccal mucosa
-palate
-lingual surface of the tongue

62
Q

What are the oral manifestations of the use of corticosteroids as treatment?

A

-immunosuppression
-susceptibility to oral candidiasis
-recurrent herpes labilis
-herpes zoster infections
-gingival and periodontal disease
-impaired wound healing

63
Q

What are some ways for dental management with those that have addisons?

A
  1. conduct treatment in the morning
  2. control anxiety annd emotional stress
  3. use long acting anesthetics
  4. treating post operative painW
64
Q

What is hyperadrenalism?

A

cushing disease

65
Q

What is the secondary disorder of hyperadrenalism?

A

ACTH-dependent cushing disease

66
Q

What can cause ACTH dependent cushing disease?

A

-adenoma of anterior pituitary that leads to large secretion of ACTH
-ectopic secretion of ACTH by non-pituitary tumor
-ectopic secretion of CRH by non-pituitary tumor

67
Q

What causes ACTH independent cushing syndrome?

A

-adenomas of the adreanl cortex overproducing cortisol
-primary nodular hyperplasia of the adrenal gland cause overproduction of cortisol

68
Q

What are some manifestations of cushing syndrome?

A

-moon faces with erythema and telangcitases
-increases fat deposition in supraclavicular fossa and dorsocervical area
-androgen excess
-diabetes mellitus

69
Q

What are the orofacial features of cushings syndrome?

A

-round, moon face
-fragile surface capillaries
-acne and excessive facial hair
-delayed growth and development
-increased pigmentation of buccal mucosa if due to ACTH excess
-immunosuppresion

70
Q

What is pheochromocytoma?

A

disease involved with an excessive secretion of EPI and NE from the chromaffin cells of the adrenal medulla
-tumor in the adrenal medulla

71
Q

What are the symptoms of pheochromocytoma?

A

-hypertension, tachycardia, palpatations, headache, sweating, tremors, weigh loss, hyperglycemia, and orthostatic hypotension

Physiology Exam 2 (6 decks)

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