Lecture 64- Adrenal Cortex

Question 1

What are the net effects of cortisol?

Answer 1

Catabolic

Question 2

What is the only time of cortisol that is biologically active?

Answer 2

Free cortisol

Question 3

Why are the effects of cortisol described as “permissive”?

Answer 3

-doesnt directly initiate actions but allows other critical processes to occur
-amplifies actions of other hormones

Question 4

What are the 4 effects of cortisol on energy metabolism?

Answer 4

1. Increases blood glucose
2. Increases glycogenesis
3. Increases lipolysis and protein catabolism
4. Increases appetite, visceral obesity

Question 5

How does cortisol increase blood glucose (3)?

Answer 5

1. Increase gluconeogenesis
2. Increase glucagon release from pancreas to allow glycogenolysis
3. Temporary causing insulin resistance in tissues

Question 6

What does cortisol inhibit?

Answer 6

Calcium absorption

Question 7

What is the effect of cortisol on the musculoskeletal system?

Answer 7

Increases protein catabolism

Question 8

What effect does cortisol have on bone, specifically? (3)

Answer 8

1. Inhibits bone formation
2. Increases bone resorption
3. Causes osteoporosis

Question 9

What effect does cortisol have on connective tissue, specifically? (2)

Answer 9

1. Inhibits collagen synthesis
2. Causes thin skin and fragile capillaries (if cortisol is high long-term)

Question 10

What effect does cortisol have on the kidneys and cardiovascular system? What does it increase and what does it decrease?

Answer 10

Has a role in water balance !!!!

Increases glomerular filtration rate in the kidney
Decreases ADH

Question 11

What does cortisol help maintain in the kidneys and cardiovascular system?

Answer 11

Maintain normal blood pressure and volume

Question 12

Which receptors does cortisol upregulate in the kidney and cardiovascular system? What is this specific receptor necessary for?

Answer 12

-upregulates alpha-1 adrenergic receptors
-necessary for vasoconstrictive response of arterioles to NE and EPI

Question 13

What effect does cortisol have on the immune system? (3)

Answer 13

1. Suppresses immune response
2. Decreases neutrophil activity, formation of cytokines, T-lymphocytes, and antibody formation
3. Specific anti-inflammatory effects

Question 14

What specific anti-inflammatory effects does cortisol have on the immune system?

Answer 14

-induces lipoprotein
-inhibits production of interleukin-2
-inhibits release of histamine

Question 15

When lipocortin is induced, it inhibits ______, thus decreasing ______ and _________.

Answer 15

Inhibits phospholipase A2

Decreasing precursors of prostaglandins and leukotrienes

Question 16

What are exogenous steroids administered?

Answer 16

Suppress the immune system and prevent rejection of transplanted organs

combat hyper immune reactions

Question 17

What is needed for androgen pathway in the zone reticularis?

Answer 17

17,20-lyase

Question 18

What are considered (3) weak androgens in the Zone reticularis? And what are these converted to in peripheral tissue?

Answer 18

1. DHEA
2. DHEA sulfate
3. Androstenedione

**Converted to testosterone and estrogen

Question 19

What is the innermost cortical layer?

Answer 19

Adrenal cortex: Zona reticularis

Question 20

What is slope is caused by?

Answer 20

-an elevation in androgens and/or sex steroids

Question 21

What are the clinical signs of hyperaldosteronism? What is the treatment?

Answer 21

Increased ECF volume, increased renal perfusion pressure

Treatment: spironolactone (aldosterone antagonist)

Question 22

How does the primary form of hyperaldosteronism differ from the secondary form?

Answer 22

Primary form: idiopathic adrenal hyperplasia. Tumors are present.
Secondary form: liver disease, kidney disease (RAAS pathway is activated, BP increases)

Question 23

What are the causes of Addison’s disease (hypoadrenocorticism)?

Answer 23

Auto-immune, infiltrative disease, idiopathic, iatrogenic steroids

*anything that could destroy adrenal gland (tumor, hemmoraghe)
*cancer (accumulation or diffusion in cells or tissues of substances normally not found)

Question 24

What does the loss of cortisol in addisons disease result in?

Answer 24

Decreased gluconeogenesis and blood glucose

Question 25

What does the loss of aldosterone in addisons disease result in? (There are a lot RIP)

Answer 25

Increased K+ , decreased blood volume, decreased Na+, bradycardia, irregular heartbeat, circulatory collapse

Question 26

What is another name for hypoadrenocorticism?

Answer 26

Addisons disease

Question 27

What is another name for hyperadrenocorticism?

Answer 27

Cushing’s syndrome

Question 28

What are the causes of Cushing’s syndrome?

Answer 28

Excess cortisol production, pituitary adenoma secreting excess ACTH, loss of tonic dopamine inhibition of ACTH, adrenal tumors

Question 29

What is pars intermedia dysfunction? What species is it common in? (related to Cushings syndrome)

Answer 29

Loss of tonic dopamine inhibition of ACTH

Common in horses

Question 30

What does chronic excessive exogenous steroid administration result in ?

Answer 30

Latrogenic hyperadrenocorticism