Hypothalamic-Pituitary Relationships and Biofeedback Part 2 - DR L-H

Question 1

____ ____ are located immediately above the kidneys.

Answer 1

Adrenal glands

Question 2

Zona glomerulosa secretes ____.

Answer 2

aldosterone

Question 3

Zona fasciculata and zona reticularis secrete _____ and _____.

Answer 3

cortisol; androgens

Question 4

The medulla secretes ______ and ______.

Answer 4

epinephrine; norepinephrine

Question 5

_____ and _____ are rapid responders to stress.

Answer 5

Epinephrine and norepinephrine

Question 6

____ is a longer-acting stress-response steroid hormone that regulates glucose utilization and immune and inflammatory homeostasis.

Answer 6

Cortisol

Question 7

_____ regulates salt and volume homeostasis.

Answer 7

Aldosterone

Question 8

The HPA axis is under negative feedback control by ____.

Answer 8

cortisol

Question 9

Describe the HPA axis.

Answer 9

CRH>ACTH>cortisol & androgens

Cortisol inhibits ACTH and CRH.

Question 10

Cortisol causes immune ____, ______, protein ____, and ____.

Answer 10

suppression; gluconeogenesis; catabolism; lipolysis

Question 11

Cortisol secretion is ___ in the morning and ___ in the late evening.

Answer 11

high; low

Question 12

Describe the regulation of aldosterone secretion.

Answer 12

Low blood volume, low BP, low Na+, or high K+ causes increased Angiotensin I production, increasing secretion of aldosterone from the adrenal cortex, causing increased absorption of Na+ and water, and increased K+ excretion, increasing blood volume and BP.

Question 13

A patient with high plasma cortisol levels and low plasma ACTH levels would have a _____ endocrine syndrome due to a ____ ___.

Answer 13

primary; adrenal tumor

Question 14

Truncal obesity, moon face, buffalo hump, purple striae, and hirsutism are all symptoms of _____ syndrome.

Answer 14

Cushing’s

Question 15

A low-dose dexamethasone tests for _____ _____, but does not specify the source of ACTH overproduction.

Answer 15

Cushing’s syndrome

Question 16

A high-dose dexamethasone tests for ____ ____, specifying CS caused by a pituitary adenoma or a non-pituitary ACTH-secreting tumor.

Answer 16

Cushing’s disease

Question 17

A high-dose dexamethasone test that results in a decrease in ACTH determines that it is _____ _____.

Answer 17

Cushing’s disease

Question 18

A high-dose dexamethasone test that results in no change in ACTH levels determines that it is caused by an ____ ____.

Answer 18

ectopic tumor

Question 19

Iatrogenic Cushing’s syndrome is caused by excess exogenous glucocorticoid drugs which cause the symptoms of excess ____, but in reality, levels of ___ are actually low.

Answer 19

cortisol; cortisol

Question 20

Cushing’s syndrome caused by an adrenal tumor will have high levels of cortisol, and ___ levels of ACTH.

Answer 20

low

Question 21

Cushing’s syndrome caused by an ectopic ACTH secreting-tumor will have high levels of cortisol, ___ levels of pituitary secreting ACTH, and ___ levels of ectopic ACTH.

Answer 21

low; high

Question 22

Cushing’s syndrome caused by an ectopic ACTH-secreting tumor will respond to a high dexamethasone test by doing what?

Answer 22

Not changing the levels of ACTH at all.

Question 23

Cushing’s disease will respond to a high dexamethasone test by doing what?

Answer 23

Decreasing ACTH due to negative feedback loop.

Question 24

Cushing’s disease will have high levels of cortisol and ___ levels of pituitary secreting ACTH.

Answer 24

high

Question 25

What causes Cushing's disease?

Answer 25

A pituitary tumor

Question 26

An adrenal tumor will cause ___ levels of ACTH.

Answer 26

low

Question 27

A pituitary tumor will cause ___ levels of ACTH.

Answer 27

high

Question 28

An ACTH-secreting ectopic tumor will cause ___ levels of ACTH.

Answer 28

very high

Question 29

Exogenous administration of glucocorticoids may ____ adrenal cells that produce cortisol.

Answer 29

atrophy

Question 30

_____ disease is an autoimmune response that attacks the adrenal cortex.

Answer 30

Addison's

Question 31

In Addison's disease, cortisol and aldosterone levels are ___ and ACTH levels are ___.

Answer 31

low; high

Question 32

Increased ACTH in a primary adrenal insufficiency causes ______ because ACTH breaks down into MSH.

Answer 32

hyperpigmentation

Question 33

Low cortisol and high ACTH is indicative of a _____ adrenal insufficiency.

Answer 33

primary

Question 34

Low cortisol and low or normal ACTH is indicative of a ______ or ______ adrenal insufficiency.

Answer 34

secondary; tertiary

Question 35

Why is there a low or normal ACTH level in a secondary or tertiary adrenal insufficiency?

Answer 35

The renin-angiotensin-aldosterone system still exists.

Question 36

Low cortisol and low aldosterone is indicative of a _____ adrenal insufficiency.

Answer 36

primary

Question 37

Low cortisol levels and normal aldosterone levels is indicative of a _____ or ____ adrenal insufficiency.

Answer 37

secondary; tertiary

Question 38

Addison's disease is a ____ adrenal insufficiency.

Answer 38

primary

Question 39

There is hyperpigmentation in _____ ____ and in ______ ______.

Answer 39

Cushing's disease; Addison's disease

Question 40

____ hyperaldosteronism is an excessive release of aldosterone from the adrenal cortex.

Answer 40

Primary

Question 41

____ hyperaldosteronism is caused by excessive renin secretion by the juxtaglomerular cells in the kidney.

Answer 41

Secondary

Question 42

_____ can be caused by destruction of the adrenal cortex, defects in aldosterone synthesis, or inadequate stimulation of aldosterone secretion.

Answer 42

Hypoaldosteronism

Question 43

____ syndrome is an adenoma in the adrenal cortex which causes primary hyperaldosteronism.

Answer 43

Conn's

Question 44

Bilateral adrenal hyperplasia can cause ______ _________.

Answer 44

primary hyperaldosteronism

Question 45

Defects in __-___-hydroxylase leads to no androgen release or cortisol release, so presents with no secondary sex characteristics and HTN.

Answer 45

17-alpha

Question 46

Defects in __-___-hydroxylase leads to no aldosterone or cortisol release, so presents with ambiguus secondary sex characteristics and hypotension.

Answer 46

21-beta

Question 47

Defects in __-___-hydroxylase leads to no aldosterone or cortisol release, so presents with ambiguus secondary sex characteristics and hypertension (due to increased DOC).

Answer 47

11-beta

Question 48

A defect in __-___-_____ leads to increased progesterone and 17-OH progesterone.

Answer 48

21-beta-hydroxylase

Question 49

A defect in __-___-_____ leads to increased 11-DOC and 11-deoxycortisol.

Answer 49

11-beta-hydroxylase

Question 50

A defect in __-___-_____ leads to increased Pregnenolone and progesterone.

Answer 50

17-alpha-hydroxylase

Question 51

All congenital adrenal enzyme deficiencies are characterized by an _____ of the adrenal glands.

Answer 51

enlargement

Question 52

Enlargement of the adrenal glands can be caused by ____ ACTH stimulation by ____ cortisol.

Answer 52

increased; decreased

Question 53

Decreased cortisol synthesis caused negative feedback from the pituitary to increase ___, causing adrenal _____.

Answer 53

ACTH; hyperplasia

Question 54

A defect in 17-alpha-hydroxylase causes decreased _______.

Answer 54

androstenedione

Question 55

A defect in 21-beta-hydroxylase causes increased ____ and 17-hydroxy-progesterone.

Answer 55

renin

Question 56

A defect in 11-beta-hydroxylase causes decreased ____.

Answer 56

renin

Question 57

A _____ causes increased secretion of catecholamines (epinephrine and norepinephrine) and presents with HTN, HAs, palpitations, and sweating.

Answer 57

pheochromocytoma

Question 58

The adrenal medulla produces catecholamines (______ and ______).

Answer 58

epinephrine and norepinephrine

Question 59

Cortisol upregulates PMNT which converts _____ to ____.

Answer 59

Norepinephrine to epinephrine

Question 60

The chemical signal for secretion of catecholamine from the adrenal medulla is _____.

Answer 60

ACh

Question 61

___ and ___ degrade catecholamines.

Answer 61

COMT; monoamine oxidase (MAO)

Question 62

Catecholamines, metanephrines, and VMA can be measured to determine total ______ production.

Answer 62

catecholamine

Question 63

The alpha receptors and B3 receptors respond better to ___ than ___.

Answer 63

norepinephrine; epinephrine

Question 64

The __ receptor responds equally to NE and E.

Answer 64

B1

Question 65

Epinephrine has a higher affinity for the __ receptor.

Answer 65

B2

Question 66

Short-term stress causes the adrenal medulla to secrete ______.

Answer 66

catecholamines

Question 67

Long-term stress causes the adrenal medulla to secrete ___ and ___.

Answer 67

mineralocorticoids; glucocorticoids

Question 68

____ is a mineralocorticoid.

Answer 68

Aldosterone

Question 69

____ is a glucocorticoid.

Answer 69

Cortisol