Hypothalamic and Pituitary Relationships and Biofeedback Part 2

Question 1

What does the Zona glomerulosa secrete?

Answer 1

Aldosterone

Question 2

What does the zona fasciculata and zona reticularis secrete?

Answer 2

Cortisol and androgens (DHEAS)

Question 3

What do the medulla chromaffin cells secrete?

Answer 3

Epi and NE

Question 4

The hypothalamic, pituitary, adrenal (HPA) axis is under negative feedback control by?

Answer 4

Cortisol

Question 5

What is cortisol’s action on the immune system?

Answer 5

Suppression

Question 6

What is cortisol’s action on the liver?

Answer 6

Gluconeogenesis

Question 7

What is cortisol’s action on muscle?

Answer 7

Protein catabolism

Question 8

What is cortisol’s action on adipose tissue?

Answer 8

Lipolysis

Question 9

When are the secretory rates of cortisol high and low?

Answer 9

High in morning and low at night

Question 10

Moon face, buffalo hump, excess weight gain in abdomen, and dark red or purple stretch marks are signs of what condition?

Answer 10

Cushing’s syndrome

Question 11

What type of dexamethasone suppression test differentiates patients with cushing syndrome of any cause from patients who do not have it?

Answer 11

Low-dose

Question 12

In a low dose dexamethasone suppression test what indicates cushing’s syndrome?

Answer 12

No ACTH suppression

Question 13

What type of dexamethasone suppression test differentiates patients with cushing syndrome caused by pituitary ACTH secreting tumor or not?

Answer 13

High-dose

Question 14

In a high dose dexamethasone suppression test, low ACTH means?

Answer 14

Pituitary tumor

Question 15

In a high dose dexamethasone suppression test, no change in ACTH means?

Answer 15

Ectopic tumor

Question 16

Iatrogenic cushing’s syndrome is caused by?

Answer 16

Exogenous glucocorticoid excess

Question 17

What is derived from post-translational processing of pro-opiomelanocortin (POMC)?

Answer 17

ACTH

Question 18

Increased ACTH and hyperpigmentation can be seen in what condition?

Answer 18

Addison’s disease

Question 19

Cosyntropin (synthetic ACTH) stimulation test is used to detect?

Answer 19

Adrenal gland insufficneincy

Question 20

Both cortisol and aldosterone secretion is decreased in what type of adrenal insufficiency?

Answer 20

Primary adrenal insufficiency (something wrong at adrenal cortex)

Question 21

Cortisol is decreased but renin-angiotensin-aldosterone axis is still active in what type of adrenal insufficiency?

Answer 21

Secondary or tertiary adrenal insufficiency (something wrong at anterior pituitary or Hypothalamus)

Question 22

An adrenal hemorrhage such as Waterhouse-Friderichsen syndrome, tuberculosis, or N. meningitidis can cause?

Answer 22

Addison’s disease (primary adrenal insufficiency)

Question 23

Fludrocortisone is used as a treatment of adrenal insufficiency to replace?

Answer 23

Aldosterone

Question 24

Corticosteroids such as hydrocortisone, prednison, or dexamethasone are used as a treatment of adrenal insufficiency to replace?

Answer 24

Cortisol

Question 25

Patients with increased plasma cortisol, decreased plasma CRH, decreased plasma ACTH, and no hyperpigmentation results in what disorder?

Answer 25

Primary adrenal excess

Question 26

Patients with increased plasma cortisol, decreased plasma CRH, increased plasma ACTH, and hyperpigmentation results in what disorder?

Answer 26

Secondary pituitary excess

Question 27

Patients with decreased plasma cortisol, increased plasma CRH, increased plasma ACTH, and hyperpigmentation results in what disorder?

Answer 27

Primary deficiency

Question 28

Patients with decreased plasma cortisol, increased plasma CRH, decreased plasma ACTH, and no hyperpigmentation results in what disorder?

Answer 28

Secondary deficiency

Question 29

Patients with decreased plasma cortisol, decreased plasma CRH, decreased plasma ACTH, and no hyperpigmentation results in what disorder?

Answer 29

Steroid administration (synthetics other than cortisol)

Question 30

Excessive release of aldosterone from the adrenal cortex such as Conn's is seen in?

Answer 30

Primary hyperaldosteronism

Question 31

Adenoma in the adrenal cortex is seen in what condition?

Answer 31

Conn's syndrome

Question 32

Excessive renin secretion by the juxtaglomerular cells in the kidney is seen in?

Answer 32

Secondary hyperaldosteronism

Question 33

Destruction of the adrenal cortex, defects in aldosterone synthesis, and inadequate stimulation of aldosterone secretion is seen in?

Answer 33

Hypoaldosteronism

Question 34

An increase in plasma aldosterone concentration (PAC) and decrease in plasma renin activity (PRA) results in a ratio that is used to detect?

Answer 34

Primary hyperaldosteronism

Question 35

When cholesterol is stimulated by 21-hydroxylase, 11-hydroxylase, 18-hydroxylase, and then 18-oxidase it results in what hormone?

Answer 35

Aldosterone

Question 36

When cholesterol is stimulated by 17-hydroxylase, 21-hydroxylase, and 11-hydroxylase it results in what hormone?

Answer 36

Cortisol

Question 37

The mineralocorticoid receptor is protected from activation by cortisol by what enzyme?

Answer 37

11beta-HSD2

Question 38

All congenital adrenal enzyme deficiencies are characterized by an enlargement of both adrenal glands due to?

Answer 38

Increased ACTH stimulation due to decrease in cortisol

Question 39

What enzyme is deficient in congenital adrenal hyperplasia when mineralocorticoids are increased, cortisol is decreased, sex hormones are decreased, blood pressure is increased, and potassium concentration is decreased?

Answer 39

17alpha

Question 40

What enzyme is deficient in congenital adrenal hyperplasia when mineralocorticoids are decreased, cortisol is decreased, sex hormones are increased, blood pressure is decreased, and potassium concentration is increased?

Answer 40

21beta

Question 41

What enzyme is deficient in congenital adrenal hyperplasia when mineralocorticoids are variable, cortisol is decreased, sex hormones are increased, blood pressure is increased, and potassium concentration is decreased?

Answer 41

11beta

Question 42

Most pheochromocytoma are benign, unilateral adrenal tumors that secret catecholamine that stimulate?

Answer 42

Alpha and beta adrenergic receptors

Question 43

What upregulates PNMT enzyme?

Answer 43

Cortisol

Question 44

What is the chemical signal for secretion of catecholamine from the adrenal medulla?

Answer 44

Acetylcholine

Question 45

What is a major enzyme involved in the degradation of catecholamines?

Answer 45

COMT

Question 46

Alpha and Beta-3 adrenergic receptors respond better to Epi or NE?

Answer 46

NE

Question 47

Beta-1 adrenergic receptors respond better to Epi or NE?

Answer 47

Equal

Question 48

Beta-2 adrenergic receptors respond better to Epi or NE?

Answer 48

Epi