Adrenal cortex
54 important questions on Adrenal cortex
What defines the different zones of the adrenal cortex?
What kinds of cortisol do you have?
- Free (active)
- Bound to plasma-proteins
- As a metabolite (inactive)
How does steroid transport occur?
- binding on plasma-protein
- passing the membrane
- connecting to an intracellular receptor
- promoting gene transcription
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What kind of adrenal hormones does the Zona glomerularosa produce?
How is the vascular volume regulated by mineralcorticoids?
Aldosteron is regulated by the pituitary gland (ACTH) and the Renin-angiotensin system. Which of these two has the biggest role in the regulation of Aldosteron?
What kind of hormones does the zona reticularis produce?
Why does the androgens produced by males in the adrenal gland have little effect on their secundary sexual characteristics?
By which factors is the HPA-axis influenced?
- CRH
- free cortisol
- eating
- stress
- sleep-wake rythm
What is the problem with prednisolone adminstration?
What is an adrenal crisis?
What happens when the adrenal gland is hyperfunctioning?
Increased body weight
Fatiguee
Striae
What are the physical characteristics of Cushing's disease?
- Full-moon facial characteristics
- Striae around the waist
Why should you combine the tests in the diagnosis of Cushing's Disease?
How can Cushing's disease be treated?
- Surgery of the pituitary
- Surgery of the Adrenal gland
- Radiotherapy
- Mitotane medication
What is the difference between resecting an adrenal tumor and medicational mitotane?
By what is the ZG stimulated?
By what are ZF and ZR stimulated?
What happens with the hormones during Addison’s?
·ACTH high
·DHEA low
·No Cortisolrespons on ACTH administration
How can the glucocorticoids insufficiency be treated?
How can the androgens insufficiency be treated?
How can the hyperpigmentation in Addison's disease be explained?
When the adrenal cortex insufficiency is secundary, which things are different from the primary disease?
- no salt craving
- no hyperpigmentation
- Low Na+ and K+
What causes acute adrenocortical insufficiency?
- adrenal crisis
- bilateral hemorrhagic destruction
- congenital adrenal hyperplasia
- decreased adrenal reserve
What are the symptoms of an adrenal crisis?
- Nausea
- Fever
- Lethargia
- hypovolemic vascular collapse
What happens with the cortisol rythm in an adrenal crisis?
What is characteristic in the hormonal respons of renin production?
What happens in congenital adrenal hyperplasia?
What are chroffafin cells?
What is the release cascade on NE?
- preganglionic cell
- AcT
- stimulates chromaffin cells
- Secrete NE and E
What is the first precursor of epinephrine?
What is the cascade from phenylalanine to epinephrine?
- phenylalanine
- tyrosine
- dopa
- dopamine
- norepinephrine
What ion do you need for the secretion of NE?
What receptor gives negative feedback on the NE secretion?
What is the effect of cocaine on NE?
Why do you need free fatty acids when you are under stress?
What is the main action of epinephrine?
- dilation of the bronchials
- glucose release into the blood
Why do you get pale when you are stressed?
Why do your pupils dilate during stress?
What is the VMA found in catecholamine catabolism?
What happens when your aldosterone levels drop?
- you can become hypovolemic
Which hormones are derived from cholesterol?
- testosteron
- aldosterone
- cortisol
- estrogen
What is the effect of cortisol on the immune respons?
Which hormone stimulates the excretion of aldosterone by the zona glomerulosa?
How does the renin-angiotensin system work?
- angiotensingen is released by the liver in respons to low BP
- renin converts angiotensingen to angiotensin I
- the ACE from the lungs convert angiontensin I to angiotensin II
- angiontensin II binds endothilian cells
- the blood vessels vasoconstrict
- angiotensin II also stimulates aldosterone secretion by the z. glomerulosa
- BP increases
- renin production decreases
- less angiotensin I is produced
- less angiotensin II binds endothilian cells
- the blood vessels vasodilate
- BP decreases
What are the main organs participating in the renin-angiotensin system?
- liver (angiontensinogen)
- kidneys (renin)
- adrenals (aldosterone)
- lungs (ACE)
What distinguishes Cushing's Disease from Cushing's syndrome?
What happens with ACTH production when the cortisol secretion increases?
What are the 3 steps in the diagnosis of Cushing's syndrome?
- determination endogenous hypercortisolism
- measure ACTH serum (elevated or suppresed)
- perform CT and MRI scan
How is Cushing's Disease distinguished from an adrenal tumor or ectopic ACTH in a differential biochemical analysis of ACTH?
Does an ectopic ACTH producing tumor respond to CRH or DEX administration?
What causes the hyperkalemia and the hyponatremia in Addison's disease?
How can you distuingish a primary adrenal deficiency from a secondary deficiency?
M. Addison auto-immune disease is frequently associated with other auto-immune diseases. Name some
- Hypothyroidism (Hashimoto's)
- Hyperthyroidism (Graves)
- Vitiligo
- Celiac disease
- Diabetes mellitus type I
- Pernicious anemia
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