Endocrine Function III (part 1)

Question 1

Basic anatomy of the adrenal cortex

Answer 1

(outer) capsule, adrenal cortex, adrenal medulla (inner)

Question 2

Three layers of the adrenal cortex

Answer 2

• Zona Glomerulosa (outermost)
• Zona Fasciculata (middle layer)
• Zona Reticularis (innermost layer)

Question 3

Three major hormone classes of the adrenal cortex

Answer 3

Estrane
Androsane
Pregnane

Question 4

Major hormone(s) produced by Zona Glomerulosa layer

Answer 4

Mineralocorticoids

Question 5

Major hormone(s) produced by Zona Faciculata layer

Answer 5

Glucocorticoids

Question 6

Major hormone(s) produced by Zona Reticularis layer

Answer 6

Sex Hormones

Question 7

Number of carbons on estrogens, androgens, and adrenal steroids

Answer 7

estrogens: 18
androgens: 19
adrenal steroids: 21

Question 8

First Biosynthetic pathway for adrenocorticosteroid formation

Answer 8

Acetate to Cholesterol to Pregnenolone to Adrenocorticoids

Question 9

Second Biosynthetic pathway for adrenocorticosteroid formation (not preferred)

Answer 9

Pregnenolone to DHEA to Androstenedione to Testosterone to (Estradiol)

Question 10

Causes of adrenocorticosteroids utilizing alternate pathway instead of the preferred pathway

Answer 10

Enzyme deficiencies

Question 11

Importance of enzymes in steroid biogensis

Answer 11

Takes enzymes to make conversions to final product

Question 12

Major site of steroid metabolism

Answer 12

liver

Question 13

Form of adrenocorticosteroids excreted in the urine

Answer 13

Liver is site of catabolism; water insoluble hormones must be conjugated with sulfates or glucuronic acid to be excreted in urine

Question 14

Steroid which has a neg feedback effect on adrenocorticotrophic hormone

Answer 14

Cortisol

Question 15

Name of the principle cortisol-binding protein

Answer 15

CBG

Question 16

mineralocorticoids

- metabolic effects

Answer 16

maintain sodium and potassium balance

Question 17

Most potent glucocorticoid

Answer 17

cortisol

Question 18

Most potent mineralocorticoid

Answer 18

aldosterone

Question 19

most potent adrenocortical androgen

Answer 19

Testosterone

Question 20

Four specific regulatory factors for aldosterone (order in importance)

Answer 20

1. Potassium secretion
2. Renin-angiotensin-aldosterone system
3. Total body sodium concentration
4. ACTH

Question 21

What is the role of renin-angiotensin system on the regulation of aldosterone

Answer 21

Know the system! Releases aldosterone and reabsorbs Na and releases K+

Question 22

seven metabolic effects of glucocorticoids

Answer 22

1. Promotion of gluconeogenesis and lipolysis
2. Promotion of liver glycogenesis
3. Promotion of liver glycogenolysis
4. Inhibition of protein synthesis and promotion of protein catabolism
5. Increased anti-inflammatory and immunosuppressive action
6. Decreased intestinal absorption of calcium; increased loss of calcium from bone matrix
7. Miscellaneous: enzyme production, appetite promotion; regulation of blood pressure

Question 23

Three regulatory factors for the release of glucocorticoids

Answer 23

1. ACTH stimulation of hormone
2. Normal diurnal variation
3. Stress

Question 24

feedback mechanism utilized in glucocorticoid hormonal regulation

Answer 24

Cortisol causes negative feedback on hypothalamus and anterior pituitary

Question 25

Normal diurnal variation of cortisol

Answer 25

While sleeping, cortisol is very low so negative feedback is removed; ACTH is released and there is a sharp increase while waking up (blood pressure and sugar increase so you don't pass out). The cortisol levels decrease over the day. By 4pm it should be 1/3 the level it was at 8am.

Question 26

What androgen is produced in the greatest quantity by the adrnal cortex

Answer 26

Testosterone

Question 27

List six conditions associated with a hypo functioning adrenal cortex

Answer 27

1. Primary hypoaldosteronism 2. Secondary hypoaldosteronism 3. Addison's disease 4. Acute adrenal insufficiency 5. Secondary and tertiary adrenal insufficiency

Question 28

Differentiate causes of primary hypoaldosteronism

Answer 28

Inability to adjust to stress, low NA, high K, high renin, low ALD

Question 29

Differentiate causes of secondary hypoaldosteronism

Answer 29

Occurs in patient with renal disease, kidney unable to produce and release renin and therefore cause low ALD

Question 30

List the typical sodium, potassium, and renin levels observed in hypoaldosteronism

Answer 30

Low Na, high K, high renin