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Flashcards in Adrenal Deck (37)
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1
Q

Direct precursor for cortisol?

A

11-deoxycortisol

2
Q

Direct precursor for Aldosterone?

A

Corticosterone

3
Q

Direct precursor for Androstenedione?

A

Dehydroepiandrosterone

4
Q

Angiotensin II is required for which adrenocortical hormone?

A

Aldosterone

5
Q

ACTH is necessary for conversion of cholesterol into _______.

A

Pregnenolone (precursor to aldosterone, cortisol, and androstenedione

6
Q

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

A

Necessary for Cortisol and Androstenedione

Unnecessary for Aldosterone

7
Q

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

A

Aldosteron and Cortisol and Androstenedione will not be formed

8
Q

Most cholesterol is created de novo.

T/F

A

False

Most cholesterol is bound to LDL

9
Q

All adrenocortical steroids are made from ________________.

A

Cholesterol

10
Q

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

A

It is esterified and stored in cytoplasmic vesicles until needed.

11
Q

Glucocorticoids stimulate glycogenesis.

T/F

A

F

They stimulate Gluconeogenesis

12
Q

Cortisol is what class of adrenocortical hormone?

A

Glucocorticoid

13
Q

Androstenedione is what class of adrenocortical hormone?

A

Androgen

14
Q

Aldosterone is what class of androcortical hormone?

A

Mineralcorticoid

15
Q

Glucocorticoids can suppress the thymus.

T/F

A

T

They suppress the immune system this way

16
Q

In a nutshell, glucocorticoids do what?

A

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

Decrease immune system

Increase GFR (glomerular filtration rate)

17
Q

Prolonged increase of GC often leads to

A

Diabetes Mellitus

18
Q

Dopamine, epinephrine, and norepinephrine are

A

Catacholamines

19
Q

Why are GC’s essential for survival during fasting?

A

They stimulate GNG

20
Q

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

A, B, and C all interfere with inflammation.

Blocking epinephrine does not interfere.

21
Q

Name 2 drugs that inhibit GC

A

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
Q

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

A

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

23
Q

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

A

Adrenal cortex cortisol secreting tumor

24
Q

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

A

Decrease ACTH —-> Decrease cortisol

25
Q

What stimulates aldosterone synthase?

A

Angiotensin II

26
Q

Metyrapone will prevent the synthesis of what 2 hormones?

A

Aldosterone and cortisol by shutting down 11B-hydroxylase

27
Q

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

A

Converts cortisol to cortisone

28
Q

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?

A

21B-hydroxylase deficiency

29
Q

Cushing’s SYNDROME vs Cushing’s DISEASE

A

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
Q

Shared symptoms of Cushing’s Syndrome/Disease:

A
  • 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
31
Q

Conn’s syndrome is Primary _______________

A

Hyperaldosteronism

32
Q

Conn’s syndrome is caused by aldosterone secreting tumor

T/F

A

Totally true.

33
Q

Spironolactone is used to treat what?

A

Conn’s syndrome

It’s an aldosterone antagonist…. Conn’s is caused by an aldosterone secreting tumor

34
Q

What does this stuff:

  • inhibits renin release
  • increases ECF volume
  • increases Na and H2O Reabsorption causing hypertension
  • increases H+ excretion causing metabolic alkalosis
A

Conn’s syndrome

35
Q

What issue does this patient have:

  • decreased androgens and GCs
  • increased mineralcorticoids
  • Hypertension
  • Hypokalemia
  • Metabolic alkalosis
A

17a-hydroxylase deficiency

36
Q

Your patient’s name is Sarah-Beth Jane Jitzel Eisenhower.

  • Mrs. Eisenhower’s adrenals do not produce mineralocorticoids or GCs
  • Mrs. Eisenhower shows increased production of adrenal androgens
  • She exhibits virilization and increased urinary levels or 17-ketosteroids.
  • Her ACTH levels are high
  • She shows adrenalcortical hyperplasia

What does Mrs. Eisenhower have? How would we treat?

A

She has 21b-hydroxylase deficiency

We would probably refer to someone who can prescribe replacement glucocorticoids and mineralocorticoids.

37
Q

In response to SNS stimulation, the adrenal medulla secretes mainly what substance into the blood?

A

Epinephrine