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FHB Endocrinology > L73: Adrenal Gland > Flashcards

L73: Adrenal Gland Flashcards

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1
Q

What are mineralocorticoids?

A

Hormones secreted in the Zona Glomerulosa of the Adrenal Cortex that promotes sodium retention and water retention in the kidney
Aldosterone

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2
Q

What enzyme is found in Zona Glomerulosa cells that allow them to produce Aldosterone?

A

Aldosterone Synthase

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3
Q

What are the target tissues of Aldosterone?

A 
MR highly expressed in:
Distal Tubule
Colon
Salivary Ducts
Sweat Ducts
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4
Q

What does Aldosterone do?

A

Stimulate sodium and water reabsorption

Increases potassium secretion

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5
Q

How does aldosterone cause its effects?

A

Increases transepithelial Na+ transport in distal tubule and collecting duct of nephron
Increases potassium excretion in collecting duct cells

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6
Q

What stimulates Aldosterone release?

A

Increases in EC fluid K+ conc.

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7
Q

How does the Renin-Angiotensin-Aldosteron System work?

A

Decreased BP stimulates renin release from kidney from JGA -> Renin cleaves angiotensinogen from liver to angiotensin I -> ACE converts angiotensin II -> Vasocontrictor and stimulates Aldosterone release

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8
Q

What is the net result of Aldosterone secretion?

A

Increased EC fuid volume and increased BP

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9
Q

What is the net result of AVP/ADH?

A

STimulate distal nephron water permeability -> increased water retention -> decreases plasma osmolality and decreases sodium concentration in blood

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10
Q

What does Mineralocorticoid receptor (MR) bind?

A

Binds with high affinity to both glucocorticoids and mineralocorticoids

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11
Q

Does Aldosterone have a specific binding protein?

A

No

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12
Q

What inactivates glucocorticoids in the kidney?

A

11B-HSD Type II converts cortisol to cortisone and thus inactivates it

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13
Q

What does Carbenoxolone do?

A

Inhibit 11B HSD2 -> excess MR activation

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14
Q

What produces similar results as Carbenoxolone?

A

Licorice: inhibit 11B HSD2 -> increased sodium and water retention with excessive consumption

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15
Q

What enzyme converts cortisone back to cortisol?

A

11B HSD1 : potential DM T2 drug target

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16
Q

What is produced in the Zona Reticularis of hte Adrenal Cortex?

A

Adrenal Androgens: DHEA

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17
Q

What is DHEA?

A

Precursor for testosterone and estrogen
Declines with age
Weak androgen due to low binding affinity for androgen receptors

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18
Q

What is the first step in steroid hormone biosyntehsis?

A

Conversion of cholesterol to pregnenolone

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19
Q

How are adrenal steroid hormones synthesized?

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A

Cholesterol imported into cell as LDL or HDL -> STAR transports cholesterol form outer mitochondria to inner mitochondria (rate limiting step) -> Converted to pregnenolone by CYP11A1(P450scc)

20
Q

What does cholesterol ester hydrolase do?

Study These Flashcards
A

Esterifies cholesterol; Stimulated by ACTH

21
Q

What are the common causes of congenital adrenal hyperplasia (CAH)?

Study These Flashcards
A

21a hydroxylase deficiency
11B hydroxylase deficiency

Both lead to excess ACTH stimulation of cortex due to lack of negative feedback

22
Q

What does 21ahydroxylase deficiency lead to?

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A

Excess DHEA
No glucocorticoids or mineralocoritcoids

Sx: Virilization (masculinization), ambiguous genitalia, sodium loss

23
Q

What does 11B hydroxylase deficiency lead to?

Study These Flashcards
A

Salt and water retention due to excess mineralocorticoid activity

24
Q

Where are 21a-hydroxylase found in the Adrenal Cortex? What is its gene code

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A

CYP21A2

Z. Fasciculata and Z.Glomerulosa

25
Where are 11 hydroxylase found in the Adrenal Cortex? What is its gene code
CYP11B1/CYP11B2 | Z. Fasciculata and Z.Glomerulosa
26
Where are 17a-hydroxylase found in the Adrenal Cortex? What is its gene code
CYP17 | Z.Fasciculata and Z.Reticularis
27
Where are Aldosterone Synthase found in the Adrenal Cortex? What is its gene code
CYP11B2 | ZGlomerulosa
28
Where are Desmolase/P450scc found in the Adrenal Cortex? What is its gene code
CYP11A1 | All
29
What is the major cell type found in the adrenal medulla?
Chromaffin cells (Pheochromocytes)
30
What causes Epi/NE release from the adrenal medulla?
Sympathetic nerve stimulation (ACh)
31
What innervates the adrenal medulla?
Splanchnic nerve
32
Where is epinephrine synthesized?
Only in the adrenal medulla
33
When is epinephrine release?
As response to acute stress | Rapid activation and rapid return
34
How do peripheral nerves release NE
Convert dopamine to norepinephrine
35
What does cortisol do in the adrenal medulla?
Stimulate conversion of NE to epinephrine (only in adrenal medulla)
36
What are the physiological effects of Epi?
Act through adrenergic receptors (a and B) Arousal: pupil dilation, sweating, GI and bronchial muscle relaxation Metabolic: glucose release, inc metabolic rate CV: vasoconstriction, tachycardia
37
What are the 3 main targets for the metabolic effects of Epinephrine?
Muscle:Increase glycogenolysis, dec glucose uptake Fat: inc lipolysis, dec glucose uptake Liver: inc gycogenolysis, inc gluconeogenesis,inc glucose release, inc ketogenesis
38
How does epinephrine affect pancreatic hormone secretio?
decrease insulin | increase glucagon
39
How do cortisol and Epi work together to deal with a stress response?
Cortisol: CRH ->Pituitary->ACTH ->Adrenal Cortex -> Cortisol Epi: Sympathetic neurons in hypothalamus -> spinal cord-> adrenal medulla -> epinephrine Result: Increase energy mobilization and redistribution, cardiovascular response inc, arousal, behavioral activaiton, aggression
40
How are catecholeamines metabolized?
Short half life | Degraded by COMT or MAO to produce VMA which is excreted in urine
41
How can VMA levels be clnically useful?
Metabolic byproduct of catecholeamines | Detect tumors producing excess Epi/NE
42
What are pheochromocytomas?
The 10% tumor | Tumors of chromaffin cells leading to catecholeamine overproduction
43
What are the symptoms of pheochromocytomas? How is it treated?
HTN wihtout response to medication Headaches Tachycardia Treatment: surgery and alpha/beta blockers pre surgery
44
Where are the pheochromocytomas found?
Extra-adrenal sites (10%): Sympathetic nerve chain, distal aorta, ureter, urinary bladder Adrenal Glands (90%)
45
Why are pheochromocytomas called the 10% tumor?
``` 10% are: Malignant Bilateral In children Familial Recur MEN Syndrome Stroke presented with Extraadrenal ```

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