The Adrenal Gland

Question 1

Diagram of the adrenal glands

Answer 1

Question 2

Diagram of the adrenal blood vessels

Answer 2

Question 3

What is the microanatomy of the adrenal glands

Answer 3

Question 4

What does the adrenal medulla secrete

Answer 4

Mineralocorticoids (aldosterone)

Glucocorticoids (cortisol)

Sex steroids (androgens, oestrogens)

Question 5

Whate does the adrenal cortex secrete

Answer 5

Corticosteroids

Mineralocorticoides (aldosterone)

Glucocorticoids (cortisol)

Sex steriods (androgens, oestrogens

Question 6

What does the zona glomerulosa secrete

Answer 6

Aldosterone

Question 7

What does the zona fasiculata and zona reticularis secrete

Answer 7

Cortisol (androgens, oestrogens)

Question 8

Picture of the layers of the adrenal cortex

Answer 8

Question 9

How to draw the adrenal microanatomy

Answer 9

Question 10

What is the first step of cholestrol turning into corticosteroids

Answer 10

Question 11

How does progesterone get to aldosterone

Answer 11

Answer 12

Question 13

Whole preview of cholestrol to aldosterone and cortisol

Answer 13

Question 14

What does aldosterone do

Answer 14

Stimulates Na+ reabsorption in the distal convoluted tuble and corticol collecting duct in kidney (in sweat glands, gastric glands, colon)

Stimulates K+ and H+ secretion in the distal convoluted tubule

Aldosterone switches on ATPase

Question 15

How is aldosterone regulated

Answer 15

If there is decreased renal perfusion pressure - juxtagolmerular measures BP

Increased renin secretion when BP falls

Question 16

What is the renin cascade

Answer 16

Liver makes angiotensinogen (proteins)

Renin converts that into angiotensin 1 (hormones)

ACE is the lung which converts into angiotensin 2

Angriotensin 2 regulate aldosterone release

Question 17

What does angiotensin 2 enzyme activate

Answer 17

3 hydroxysteroid dehydrogenase

21 hydroxylase

11 hydroxylase

18 hydroxylase

Question 18

How is cortisol secreted

Question 19

What is cortisol and what does it do

Answer 19

Stress hormone

Protein catabolism - breakdown protein

Hepatic gluconeogensis

Increase bloog glucose concentration

Fat metabolism

Enhanced effects of glucagon and catecholamines

Question 20

Adenohypophysis negative feedback

Answer 20

Question 21

Hypothalamo pituitary adrenal axis drawing

Answer 21

Question 22

What type of rhythm does cortisol have

Answer 22

Diurnal

Lower at midnight

Peak at 8 30

Responsibel for sleep cycle

Tells your body what day it is

It secretes cortisol in pulses

Circadian rhythm

Question 23

What are the symptoms of addison disease

Answer 23

Increase pigmentation (especially when there is no sun)

Autoimmune vvitiligo

No cortisol or aldosterone so low blood pressure

Salt loss

Eventual death

Aldosterone and cortisol deficiency

Question 24

What is the cause of primary adrenal failure

Answer 24

Autoimmune disease

TB

Pituitary starts screting lots of ACTH and MSH - melanocyte stimulating hormone

Question 25

Why do patients with Addison's disease have a good tan

Answer 25

POMC (pro-opio-melanocortin) is large precursour protein that is cleaved to form ACTH, MSH and endoprhins

Question 26

What is the urgent treatment of Addison's disease

Answer 26

Rehydrate with normal saline Dextrose to prevent hypoglycaemia Give hydrocortisone Predisolone - does a bit of the work of cortisol

Question 27

Cause of cushing syndrome

Answer 27

Tumour of adrenal or pituitary Metabolism changes and put on weight

Question 28

Symptoms of cushing syndromes

Answer 28

Adrenal gland gets bigger Fat pads - fat deposition Stop making protein and start making fat Skin gets thinner, bruising Cannot make cell in between cells in between skin so tear. Can't make protein fast enough Increase blood pressure Wound and injuries don't heal Moon face

Question 29

List four possibel causes of Cushing syndroms

Answer 29

Taking steroids Pituitary depedent Cushing disease - makes ACTH cushing disease Ectopic ACTH lung cancer Adrenal adenoma or carcinoma

Question 30

Where are catecholamines derived from

Answer 30

Tyrosine Stored in cytoplasmic granules and release in response to Ach

Question 31

How is dopamine converted to noradrenaline and adrenaline

Answer 31

Question 32

Role of catecholamines

Answer 32

Increased blood glucose, aalertness NA and Adr bound to albumin Degraded by hepatic enzymes: monoamine oxidase and catechol-o-methyl transferase