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Flashcards in Adrenal Deck (37)
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1

Direct precursor for cortisol?

11-deoxycortisol

2

Direct precursor for Aldosterone?

Corticosterone

3

Direct precursor for Androstenedione?

Dehydroepiandrosterone

4

Angiotensin II is required for which adrenocortical hormone?

Aldosterone

5

ACTH is necessary for conversion of cholesterol into _______.

Pregnenolone (precursor to aldosterone, cortisol, and androstenedione

6

17a-hydroxylase is necessary for formation of __________ and __________, and unnecessary for ________________.

Necessary for Cortisol and Androstenedione

Unnecessary for Aldosterone

7

A deficiency in 3B-hydroxysteroid dehydrogenase will prevent the formation of ________________ and _______________ and _____________

Aldosteron and Cortisol and Androstenedione will not be formed

8

Most cholesterol is created de novo.

T/F

False

Most cholesterol is bound to LDL

9

All adrenocortical steroids are made from ________________.

Cholesterol

10

What happens to cholesterol we don't need right now?

It is esterified and stored in cytoplasmic vesicles until needed.

11

Glucocorticoids stimulate glycogenesis.

T/F

F

They stimulate Gluconeogenesis

12

Cortisol is what class of adrenocortical hormone?

Glucocorticoid

13

Androstenedione is what class of adrenocortical hormone?

Androgen

14

Aldosterone is what class of androcortical hormone?

Mineralcorticoid

15

Glucocorticoids can suppress the thymus.

T/F

T

They suppress the immune system this way

16

In a nutshell, glucocorticoids do what?

Tear things down so we can make and store as much glucose as possible.

Decrease immune system

Increase GFR (glomerular filtration rate)

17

Prolonged increase of GC often leads to

Diabetes Mellitus

18

Dopamine, epinephrine, and norepinephrine are

Catacholamines

19

Why are GC's essential for survival during fasting?

They stimulate GNG

20

Which of the following effects of cortisol DOES interfere with the body's inflammatory response?

A. Induce synthesis of lipocortin
B. Inhibit the production of interleukin 2
C. Inhibit the release of histamine
D. Block the release of epinephrine

A, B, and C all interfere with inflammation.

Blocking epinephrine does not interfere.

21

Name 2 drugs that inhibit GC

Metyrapone
-Inhibits 11B-hydroxylase (prevents Aldosterone and Cortisol formation)
-used in diagnosis of adrenal insufficiency

Ketoconazole
-Inhibits cholesterol desmolase (the first enzyme converting cholesterol into all 3 hormone classes)

22

A patient with elevated levels of cortisol undergoes a dexamethasone suppression test. The high dose suppresses cortisol. What can be concluded?

The hypercortisolism is likely due to an anterior pituitary ACTH secreting tumor

23

A patient with elevated levels of cortisol undergoes a dexamethasone suppression test. The high dose does not suppress cortisol. What can be concluded?

Adrenal cortex cortisol secreting tumor

24

In a healthy person, a low dose of DXS will do what?

Decrease ACTH ----> Decrease cortisol

25

What stimulates aldosterone synthase?

Angiotensin II

26

Metyrapone will prevent the synthesis of what 2 hormones?

Aldosterone and cortisol by shutting down 11B-hydroxylase

27

In renal cells, the enxyme 11B-hydroxysteroid dehydrogenase performs what function?

Converts cortisol to cortisone

28

In a chromosomal XX female, masculinization is observed, including malformed external genitalia.

Urinalysis shows an elevation of 17-ketosteroids. These findings are indicative of what?

21B-hydroxylase deficiency

29

Cushing's SYNDROME vs Cushing's DISEASE

Syndrome: Chronic excess of GC due to overproduction of CORTISOL by ADRENAL CORTEX (or pharma overdose)

Disease: Excess GC due to hypersecretion of ACTH for a PITUITARY ADENOMA. Same symptoms as the syndrome except ACTH is high.

30

Shared symptoms of Cushing's Syndrome/Disease:

- Hyperglycemia
- Proteolysis / muscle wasting
- Decreased insulin sensitivity
- Increased fat mobilization
- perodoxical fat accumulation in face, shouders, and abdomen
- moon face, buffalo hump, truncal obesity
- Poor wound healing
- Osteoporosis
- Loss of CT = stretch marks / striae
- Hypertension
- Virilization and menstral disorders in females