The Adrenal Glands Flashcards

1
Q

What are the hormones of the adrenal glands?

A

In the Zona glomerulosa there are mineralocorticoids, e.g. aldosterone. In the Zona fasiculatathere are glucocorticoids 3.g. cortisol. In the Zona reticularis there are androgens, e.g. androstenedione.

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2
Q

What are steroid hormones.

A

Lipid soluble hormones synthesised from cholesterol in adrenal glands and gonads. They bind to receptors of the nuclear receptor family to modulate gene transcription.

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3
Q

How do corticosteroids exert their actions?

A

They readily diffuse across plasma membrane and bind to glucocorticoid receptors causing dissociation of chaperone proteins. Receptor ligand complex translocates to nucleus, receptors bind to GREs or other transcription factors.

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4
Q

What is aldosterone?

A

A staid hormone which plays a central role in regulation of plasma Na+, K+ and arterial BP. The aldosterone receptor is intracellular and exerts its actions by regulating gene transcription.

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5
Q

Describe primary and secondary hyperaldosteronsim.

A

Primary is a defect in the adrenal cortex, it has low renin levels, secondary is due to over activity of the RAAS and has high renin levels.

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6
Q

What are the signs for hyperaldosteronism?

A

High BP, LV hypertrophy, stroke, hypernatraemia and hypokalaemia.

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7
Q

What’s the treatment for hyperaldosteronism?

A

Aldosterone-producing adenomas removed by surgery, spironolactone (mineralocorticoid receptor antagonist).

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8
Q

Describe role of cortisol.

A

Released by ZF in response to ACTH, negative feedback to hypothalamus inhibits CRH and ACTH release.

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9
Q

What are the actions of cortisol?

A

Increase protein breakdown in muscle, increase lipolysis in fat and increased gluconeogenesis in liver. Resistance to stress, anti-inflammatory effects and depression of immune response.

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10
Q

What are the net effects of glucocorticoid actions on metabolism?

A

Increase glucose production, breakdown of proteins and redistribution of fat.

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11
Q

What are some causes of Cushing’s syndrome?

A

External causes: prescribed glucocorticoids. Endogenous causes: excess cortisol produced by adrenal tumour, benign pituitary adenoma secreting ACTH.

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12
Q

Signs and symptoms of Cushing’s syndrome.

A

Moon-shaped face, ‘buffalo hump’, abdominal obesity, purple striae, hyperglycaemia and hypertension

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13
Q

What are steroid drugs used to treat?

A

Used to treat inflammatory disorders, e.g. asthma, inflammatory bowel disease, rheumatoid arthritis. Examples of drugs are prednisolone and dexamethasone.

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14
Q

How should steroid dosage be reduced?

A

It should be reduced gradually and not stopped suddenly.

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15
Q

What is Addison’s disease + signs & symptoms?

A

It is chronic adrenal insufficiency. Signs and symptoms: postural hypertension, lethargy, weight loss, increased skin pigmentation, hypoglycaemia.

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16
Q

Cause of hyperpigmentation in Addison’s.

A

Decreased cortisol -> negative feedback on anterior pituitary reduced -> more POMC require to synthesise ACTH -> ACTH + MSH.

17
Q

What is Addisonian crisis and what causes it?

A

A life threatening emergency due to adrenal insufficiency. Caused by severe stress, salt deprivation, infection, trauma.

18
Q

Symptoms and treatment of Addisonian crisis.

A

Symptoms: nausea, vomiting, pyrexia, hypotension. Treatment: fluid replacement, cortisol.

19
Q

What are androgens?

A

Steroid hormone partially regulated by ACTH and CRH, they promote axillary and pubic hair growth in both sexes.

20
Q

Effect of adrenaline in heart, lungs and blood vessels.

A

Heart: increases HR and contractility (β1), Lungs: Bronchodilation (β2), Blood vessels: Vasoconstriction (α1), Vasodilation (β2).