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46 Cards in this Set
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What is the order of the zones of the adrenal gland and what hormones are produced in each?
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1) glomerulosa - aldosterone
2) fasciculata - cortisol and corticosterone and small amounts of androgens 3) reticularis - DHEA, androstenedione |
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What induces aldosterone release?
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angiotensin II and potassium
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Where does ACTH act?
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at the fasiculata and reticularis increasing both androgens and cortisol
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excess ACTH can cause hypertrophy of what?
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glomerulosa and fasiculata
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ACTH increases what plasma membrane receptor?
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LDL
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what step is involved in all 3 layer of the adrenal cortex?
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cholesterol to pregnenolone
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After progesterone what is the next product and the next and the next?
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1) 11-deoxycorticosterone
2) corticosterone 3) aldosterone |
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In large quantity what can cortisol act like?
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aldosterone
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how potent is cortisone? What about prednisone?
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1) almost as potent as cortisol
2) 4x as potent as cortisol |
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How potent is methylprednisone?
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5x as potent
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How potent is dexamethasone?
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30x as potent
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What does cortisol bind in the blood?
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cortisol binding protein, transcortin and somewhat to albumin
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What is the half life of cortisol?
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60-90 min
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Aldosterone has a half life of 20 minutes which is much shorter than cortisol. Why?
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it does not bind as much to plasma proteins
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How are adrenal hormones removed from body?
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primarily conjugation with glucuronic acid released from kidneys and some from liver
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aldosterone deficiency causes what?
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hyponatremia and hyperkalemia
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what process counteracts excess aldosterone induced increased BP?
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pressure natriuresis and pressure diuresis these together comprise the aldosterone escape
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besides inducing loss of K+ in urine, aldosterone also decreases it in the extracellular fluid by?
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increasing its transport into cells
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what is the normal value of plasma K+?`
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4.5mEq/L
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aldosterone exchanges Na for K. what other cation does it cause Na exchange of?
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H+ in intercalated cells of CCT
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What effect does aldosterone have on the formation of Na/K ATPase?
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increases it
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Does aldosterone have an immediate effect?
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no it is delayed until Na/K ATPase levels can increase (30 min)
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What is the effect of ACTH on aldosterone secretion?
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it is needed for secretion but has little effect on the rate of secretion
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Adding an ACE inhibitor has what effect on cortisol?
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it increases it
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What effect does coritsol have on amino acids?
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increases enzymes that promote their use in gluconeogenesis
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Does cortisol liberate amino acids for muscle or the liver preferentially?
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muscle
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what effect does cortisol have on glucose utilization in most cells?
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decreases its utilization
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high cortisol has what effect on insulin?
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increases it
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prolonged cortisol can induce what secondary condition?
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adrenal diabetes
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What is the effect of cortisol on plasma proteins?
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it enhances liver proteins
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Does cortisol increase or decrease transport of amino acids into the liver cells?
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increases
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If alpha-glycerophosphate is decreased by cortisol what happens?
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deposition of fatty acids is decreased and lipolysis occurs
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What does cortisol do to food intake?
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increases it
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What effects does cortisol have on reducing inflammation?
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1) block early stages of inflammation
2) resolve longterm inflammation and increase healing 3) stabilize lysosomal membranes 5) decrease permeability of capillaries 6) decreases migration of WBC 7) decreases lymphocyte reproduction 8) reduces IL-1 |
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What types of diseases is cortisol used in?
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rheumatoid arthritis, rheumatic fever, acute glomerulonephritis
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Does cortisol have an effect on allergic responses even though they are acute?
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yes
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What immune cells does cortisol decrease in the blood?
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eosinophils and lymphocytes
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When cortisol is elevated what cell is increased?
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RBCs resulting in polycythemia and anemia when decreased
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Where does cortisol feedback to to reduce ACTH?
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both hypothalamus and pituitary
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When are CRF, ACTH and cortisol highest in a 24 hour period?
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in the early morning and very low in the evening
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What diseases is ACTH high in? What other products will be high?
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1) Addisons disease
2) POMC products like MSH, beta-lipotropin, beta-endorphin |
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What frequently causes destruction of adrenal glands?
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TB and cancer metastisis
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Someone presents with darkened blotchy mucous membranes and on skin of nipples. what do suspect?
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addisons
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What is Conn syndrome? What are symptoms?
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1) tumor of zona glomerulosa producing excess aldosterone
2) occasional muscle paralysis from hypokalemia, also have hypertension |
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What is a marker used to diagnose primary aldosteronism?
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renin because it will always be decreased
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what are the 17-ketosteroids?
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androngens from reticulata of adrenals
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