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Flashcards in Adrenal Gland Deck (84)
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1

Embryological origin of adrenal cortex vs. adrenal medulla

Adrenal cortex is of mesodermal origin

Adrenal medulla is of ectodermal origin

2

What types of hormones are secreted by adrenal cortex vs. adrenal medulla?

Adrenal cortex = corticoids and androgens

Adrenal medulla = catecholamines (NE and E)

3

What are the zones of the adrenal cortex?

[capsule]
Zona glomerulosa
Zona fasciculata
Zona reticularis
[adrenal medulla]

4

What is the primary hormone secreted from zona glomerulosa of adrenal cortex?

Mineralocorticoid = aldosterone

5

What is the primary hormone secreted from zona fasciculata of adrenal cortex?

Gluococorticoid = cortisol

[also some androgen secretion]

6

What is the primary hormone secreted from zona reticularis of adrenal cortex?

Androgens


[some cortisol as well]

7

What is the most common adrenal enzyme deficiency?

21-hydroxylase deficiency

8

A deficiency in 21-hydroxylase results in what changes in hormone production?

Decreased cortisol

Decreased mineralocorticoid

Increased sex hormones

9

What are signs/symptoms of 21-hydroxylase deficiency?

Hypotension (decreased aldosterone)

Sodium and volume loss

Hyperkalemia

Elevated renin

Female = virilization of fetus and sexual ambiguity at birth

Male = phenotypically normal, precocious pseudopuberty, premature growth plate closure

10

Tx for 21-hydroxylase deficiency

Replace glucocorticoids and mineralocorticoids

11

A deficiency in what adrenal enzyme leads to increased androgens, virilization of female features, and increased 11-deoxycorticosterone?

11b-hydroxylase deficiency

12

Signs and symptoms of 11b-hydroxylase deficiency

Hypertension
Hypokalemia
Suppressed renin secretion

13

A 17-alpha hydroxylase deficiency is extremely rare. What changes in hormone secretion occur with this deficiency?

Decreased androgens and cortisol

Excess mineralocorticoids

[patients typically diagnosed at puberty]

14

Signs/symptoms of 17-alpha hydroxylase deficiency

Hypertension
Hypokalemia
Hypogonadism

15

Do the following increase or decrease in a 17-alpha hydroxylase deficiency?

Mineralocorticoids
Cortisol
Sex hormones
Blood pressure
Plasma [K]

Mineralocorticoids increase
Cortisol decrease
Sex hormones decrease
Blood pressure increase
Plasma [K] decrease

16

Do the following increase or decrease in a 21-beta hydroxylase deficiency?

Mineralocorticoids
Cortisol
Sex hormones
Blood pressure
Plasma [K]

Mineralocorticoids decrease
Cortisol decrease
Sex hormones increase
Blood pressuredecrease
Plasma [K] increase

17

Do the following increase or decrease in an 11-beta-hydroxylase deficiency?

Mineralocorticoids
Cortisol
Sex hormones
Blood pressure
Plasma [K]

Mineralocorticoids decrease (aldosterone)
Cortisol decrease
Sex hormones increase
Blood pressure increase
Plasma [K] decrease

18

The target tissues of cortisol are body wide and the actions numerous. Genomic actions occur via ______, and non-genomic actions occur via _____

Glucocorticoid response elements (GREs)

Endocannabinoids

19

What conditions occur with glucocorticoid excess?

Cushing syndrome or cushing disease

20

What conditions occur with glucocorticoid deficiency?

Addison disease

21

What effect does cortisol have on the liver?

Increased gluconeogenesis

22

What effect does cortisol have on the muscle?

Breakdown of muscle protein

23

What effect does cortisol have on fat?

Promotes lipolysis in extremities, promotes central fat deposition

24

What effect does cortisol have on skin?

Skin thins, fragile blood vessels

25

What effect does cortisol have on the immune system?

Increased risk of infection (diminished immune response)

26

What effect does cortisol have on the endocrine system?

Insulin resistance or glucose intolerance

[also decreased LH, FSH release, decreased TSH release, decreased GH secretion

27

What effect does cortisol have on the GI system?

Increased risk of osteoporosis d/t interference with calcium absorption

28

Cortisol release begins with stimulationg by ____ from the ______ nucleus in the hypothalamus

This binds the CRF1 receptor (GPCR) and stimulates the release of ______, which acts on the adrenals and stimulates release of cortisol

CRF aka CRH; paraventricular

ACTH

29

ACTH is produced in the anterior pituitary and is the principle hormone that stimulates adrenal glucocorticoids

The precursor to ACTH is ______; it also contains ____ activity responsible for stimulation of melanocytes

POMC; MSH

30

Excess ACTH can lead to ______ due to increased alpha-MSH activity

Hyperpigmentation