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Neuroendocrine > Hypothalamic and Pituitary relations part 2 > Flashcards

Hypothalamic and Pituitary relations part 2 Flashcards

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1
Q

Where are the Adrenal Glands located?

A

Above the kidneys

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2
Q

What does the Hypothalamus release to the Anterior Pituitary in the HPA axis?

A

CRH

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3
Q

What does the Anterior Pituitary release to the Adrenal cortex in the HPA axis?

A

ACTH

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4
Q

What does the Adrenal cortex release in response to ACTH?

A

Cortisol

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5
Q

HPA axis

A

Hypothalamic-Pituitary-Adrenal Axis

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6
Q

What are the main functions of Cortisol?

A

Immune suppression
Gluconeogenesis
Protein Catabolism
Lipolysis

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7
Q

What activates the Hypothalamus to release CRH?

A

Stress and the Circadian Rhythm

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8
Q

Cortisol is released due to what acting on the Hypothalamus?

A

Stress and the Circadian Rhythm

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9
Q

Where does Cortisol have negative feedback?

A

At the Anterior pituitary (ACTH) and at the Hypothalamus (CRH)

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10
Q

Do Androgens have negative feedback?

A

NO

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11
Q

What are the 3 zones of the Adrenal Cortex?

A

Zona Granulosa
Zona Fasciculata
Zona Reticularis

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12
Q

Zona Granulosa releases?

A

Mineralcorticoids - Aldosterone

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13
Q

Zona Fasciculata releases?

A

Glucocorticoids - Cortisol

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14
Q

Zona Reticularis releases?

A

Androgens - secondary sex characteristics

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15
Q

When are ACTH and Cortisol secretion rates the highest?

A

In the morning

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16
Q

When are ACTH and cortisol secretion rates the lowest?

A

In the evening

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17
Q

What activates the release of Aldosterone?

A

Low sodium/High potassium OR

LOW BP

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18
Q

Describe the pathway for how to release Aldosterone from the Adrenal Cortex

A
  • Low sodium/High potassium or LOW BP act on the Kidney to release Renin
  • Renin activates Angiotensin to Angiotensin 1 which then goes to Angiotensin 2
  • Angiotensin 2 acts on the Zona Glomerulosa to release Aldosterone
  • Increased sodium/water absorption and increased BP
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19
Q

What does the kidney release to help activate Aldosterone secretion?

A

Renin

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20
Q

Where is the Angiotensin cascade found?

A

Liver

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21
Q

Where does low sodium/high potassium or Low BP act to activate Aldosterone release?

A

Kidney

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22
Q

Hypersecretion of glucocorticoids (cortisol)

A

Cushing’s Disease

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23
Q

Symptoms of Cushing’s Disease

A

Truncal obesity, buffalo hump, moon face, purple striae, high BP, easy bruising

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24
Q

What test can distinguish what is causing the increased cortisol levels for Cushing’s Disease?

Study These Flashcards
A

High-Dose Dexamethasone Suppression Test

25
What is the expected response of the HIGH-Dose Dexamethasone Suppression Test?
Decreased levels of ACTH that lead to decreased Cortisol levels
26
Describe the results of Cushing's Disease caused by an Adrenal Tumor
Low CRH Low ACTH HIGH Cortisol
27
Describe the results of Cushing's Disease caused by an Anterior Pituitary Tumor
Low CRH HIGH ACTH HIGH Cortisol
28
Describe the results of Cushing's Disease caused by an Ectopic secreting ACTH tumor
Low CRH Low ACTH at pituitary HIGH ACTH from another source HIGH cortisol
29
Describe the results of Cushing's Disease caused by exogenous glucocorticoid drugs
Low CRH Low ACTH LOW cortisol
30
Why are all outputs low if Cushing's Disease is caused by exogenous glucocorticoid drugs?
Exogenous glucocorticoids have the same negative feedback loop as real cortisol, thus all levels of the hormones will be low from their regular source
31
What may atrophy due to exogenous glucocorticoid drug intake?
Adrenal cortex cells that normally produce cortisol (fasciulata)
32
What are a few exogenous glucocorticoid drugs?
Prednisone Methylprednison Dexamethasone
33
What is the action of Aldosterone?
Increase sodium and water absorption and Increase BP
34
Increased levels of ACTH can lead to?
Hyperpigmentation (skin darkening)
35
Hyposecretion of mineralcorticoids and glucocorticoids
Addison's Disease
36
Addison's disease may also be known as
Adrenal Gland insufficiency
37
What test can be used to detect Adrenal Gland insufficiency?
Cosyntropin (synthetic ACTH) stimulation test
38
Low morning cortisol levels (normal is high) can confirm what?
Adrenal gland insufficiency
39
If morning cortisol levels are low and ACTH is high, what is the diagnosis?
Primary Adrenal Gland insufficiency
40
What are the levels of Cortisol and Aldosterone for Primary Adrenal Gland Insufficiency?
BOTH LOW
41
If morning cortisol levels are low and ACTH is low/normal, what is the diagnosis?
Secondary/Tertiary Adrenal Gland insufficiency
42
What are the levels of Cortisol and Aldosterone for Secondary/Tertiary Adrenal Gland insufficiency?
LOW cortisol | ALDOSTERONE IS NORMAL due to Renin system being unaffected in the liver
43
Main physical sign of Primary adrenal gland insufficiency?
Hyperpigmentation - due to high ACTH and low cortisol
44
Excessive release of Aldosterone, may be due to Adenoma in Adrenal cortex
Primary Hyperaldosteronism
45
Excessive release of Renin that causes excess Aldosterone
Secondary Hyperaldosteronism
46
What characterizes congenital enzyme deficiencies relating to the adrenal glands?
Enlargement of the adrenal glands due to HIGH levels of ACTH because the cortisol is LOW and thus there is an absence of (-) feedback on ACTH
47
Adrenal Hyperplasia
Enlargement of adrenal glands
48
17 alpha enzyme deficiency
``` HIGH aldosterone = HIGH BP LOW androgens (sex hormones) = underdeveloped ```
49
21 beta enzyme deficiency
``` LOW aldosterone = LOW BP HIGH androgens (sex hormones) = early puberty, virilization ```
50
11 beta enzyme deficiency
``` LOW aldosterone , but somehow HIGH BP HIGH androgens (sex hormones) = virilization LOW renin activity ```
51
What are the levels of cortisol in all congenital enzyme deficiencies for the adrenal cortex?
LOW
52
What is virilization?
Male hair growth characteristics on females
53
What is a pheochromocytoma?
Benign, unilateral tumor that secretes catecholamines
54
Catecholamines
Norepinephrine and Epinephrine
55
What stimulates release of NE and E?
Acetylcholine
56
How do you diagnose a pheochromocytoma?
Increased NE/Epi and increased metabolic byproducts
57
What are the symptoms you would see with increased catecholamines?
Sweating, Hypertension, palpitations, headaches
58
Which catecholamine is synthesized in a vesicle?
Norepinephrine

Neuroendocrine (47 decks)

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