Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
70 Cards in this Set
- Front
- Back
|
3 Zonas in the adrenal:
what does each produce? |
GFR
-Glomerulosa - Aldosterone -Fasciculata - Glucocorticoids -Reticularis - Androgens |
|
|
How does GFR correspond with salt sugar and sex?
|
The deeper you go the sweeter it gets
|
|
|
Most common tumor of the adrenal medulla in adults:
|
PHEOCHROMOCYTOMA
|
|
|
Most common tumor of adrenal medulla in CHILDREN
|
NEUROBLASTOMA
|
|
|
Which tumor causes episodic hypertension?
|
PHEO ONLY
|
|
|
Embryonic tissue from which each adrenal layer is derived:
-Cortex -Medulla |
Cortex = mesoderm
Medulla = neural crest |
|
|
What is the primary regulator of release from Zona glomerulosa?
|
RENIN
|
|
|
What is the primary regulator of release from Zona fasciculata?
|
ACTH/hypothalamic CRH
|
|
|
What is the primary regulator of release from Zona reticularis?
|
ACTH/hypothalamic CRH
|
|
|
What is the primary regulator of release from the adrenal medulla?
|
SNS
|
|
|
What type of fibers stimulate the adrenall medulla?
|
PREganglionic sympathetic fibers
|
|
|
What are the cells in the medulla and what do they secrete?
|
Chromaffin cells - Epi 80%, NE 20%
|
|
|
What is unique about the veinous drainage from the Adrenal gland?
|
It is assymetric
|
|
|
What is the veinous drainage from the RIGHT adrenal?
|
1. Right adrenal vein
2. IVC |
|
|
What is the veinous drainage from the LEFT adrenal?
|
1. Left adrenal vein
2. Left RENAL vein 3. IVC |
|
|
What is the posterior pituitary derived from?
|
Neuroectoderm
|
|
|
What does the post pit release?
|
ADH/Oxytocin
|
|
|
What is the anterior pituitary derived from?
|
ORAL ectoderm
|
|
|
What do Acidophils secrete?
|
Prolactin and GH
|
|
|
What do Basophils secrete?
|
FLAT
-FSH -LH -ACTH -TSH |
|
|
What hormones share the same alpha subunit?
|
Filth
FSH/LH/TSH/HcG |
|
|
What gives them specificity?
|
Different B-subunits
|
|
|
What are the cells that make up Islets of Langerhans in the pancreas?
|
alpha/beta/delta
|
|
|
Where are the islets most numerous in the pancreas?
|
TAIL
|
|
|
What do the islets develop from?
|
Pancreatic BUDS
|
|
|
What does each cell secrete, and where is it located within an islet?
|
alpha - Glucagon - peripheral
beta - Insulin - central delta - Somatostatin - interspersed |
|
|
What inhibits Prolactin release?
|
Dopamine
|
|
|
What stimulates Dopamine release?
|
Prolactin
|
|
|
What can stimulate Prolactin release?
|
Thyrotropin Releasing hormone TRH
|
|
|
So what do Dopamine agonists do? What is one?
|
Inhibit Prolactin release - Bromocriptine
|
|
|
What do Dopamine ANTAGonists do? What are some?
|
Allow for Prolactin release! Antipsychotics
|
|
|
Why do young females with Prolactinomas present earlier and with smaller tumors than older folks?
|
Because the increased Prolactin inhibits GnRH which inhibits FSH/LH release and causes ANOVULATION AND AMENORRHEA
|
|
|
So what is amenorrhea due to overproduction of Prolactin treated with?
|
Bromocriptine
|
|
|
What does TRH from the hypothal do to the pituitary?
|
Stimulates Prolactin and TSH
|
|
|
What does Dopamine from the hypothal do to the pituitary?
|
Inhibits prolactin release
|
|
|
What does CRH from the hypothal do to the pituitary?
|
Stimulates ACTH release
|
|
|
What does GHRH from the hypothal do to the pituitary?
|
Stimulates Growth hormone release
|
|
|
What does Somatostatin from the hypothal do to the pituitary?
|
Inhibits GH and TSH release
|
|
|
What does GnRH from the hypothal do to the pituitary?
|
Stimulates FSH/LH release
|
|
|
What is the first step in steroid hormone synthesis in the adrenals? Enzyme?
|
Cholesterol to Pregnenolone
-Desmolase |
|
|
What stimulates or inhibits desmolase?
|
Stim: ACTH
Inhibit: Ketoconazole |
|
|
What does Pregnenolone get converted to and by what?
|
-Progesterone by 3B-hydroxysteroid dehydrogenas
or -17-OHpregnenolone by 17-alpha-hydroxylase |
|
|
What does Progesterone get converted to and by what?
|
-11-deoxycorticosterone by 21-B hydroxylase
OR -17-OHprogesterone by 17-alpha hydroxylase |
|
|
What does 11-deoxycorticosterone get converted to by what enzyme?
|
Corticosterone by 11-betahydroxylase
|
|
|
What does Corticosterone get converted to and by what enzyme?
|
ALDOSTERONE! By aldosterone synthase
|
|
|
Where does Aldosterone synthesis occur? How many carbons? What class of steroids?
|
-Glomerulosa
-21 C -Mineralocorticoids |
|
|
What enzyme stimulates aldosterone synthase?
|
Angiotensin II
|
|
|
What does 17-OHprogesterone get converted to? What enzyme?
|
-11-deoxycortisol by 21-B-hydroxylase
OR -Androstenedione |
|
|
What does 11-deoxycortisol get converted to? What enzyme? Where? How many carbons? What class?
|
Cortisol
11-B-hydroxylase -fasciculata -21C -Glucocorticoids |
|
|
What can 17-OHpregnenelone get converted to?
|
DHEA - dehydroepiandrosterone
|
|
|
What can DHEA get converted to?
|
Androstenedione
|
|
|
What does Androstenedione get converted to?
|
-Estrone
OR -Testosterone |
|
|
What can Testosterone be converted to?
|
-DHT dihydrotestosterone
OR -Estradiol |
|
|
Where do the Estrogens get converted, and how many carbons? What enzyme makes Estradiol?
|
In the PERIPHERY
-18 carbons -Aromatase |
|
|
Where do the Androgens get made, how many carbons, and what enzyme makes DHT?
|
-Zona reticularis
-19 carbons -5a-reductase |
|
|
What are "Congenital bilateral adrenal hyperplasias"?
|
Conditions in which there is lack of the very important enzymes for making steroid hormones in BOTH adrenal glands!
|
|
|
What is the most COMMON enzyme deficiency in CBAH? What are the other 2, though less frequent?
|
21-Beta hydroxylase deficiency
17-alpha hydroxylase deficiency 11-beta-hydroxylase deficiency |
|
|
If you lack 17a-hydroxylase, what won't be made and what will?
|
WON'T make: Glucocorticoids or Androgens/Estrogens
WILL make: Mineralocorticoids |
|
|
So what are the 3 clinical findings in 17-AHYDROXYLASE deficiency?
|
-HYPERTENSION dt too much Na/H2O
-HYPOkalemia - over-excretion -Female phenotype but NO maturation |
|
|
Why is there a female phenotype?
|
No androgens, which are necessary for male development
|
|
|
But what is the MOST COMMON form of congenital bilateral adrenal hyperplasia?
|
21-alpha hydroxylase deficiency
|
|
|
What WON'T get made and what WILL GET MADE if 21-a hydroxylase is deficient?
|
WON'T make: Mineralocorticoids or Glucocorticoids
WILL make: Androgens! |
|
|
By the way, why is there HYPERPLASIA in these deficiencies?
|
Because lack of cortisol stimulates ACTH release from the pituitary which causes adrenal hyperplasia
|
|
|
What is the result of the overproduction of androgens in 21-ahydroxylase deficiency?
|
Masculinization
Female pseudohermaphroditism |
|
|
What is the result of lack of mineralocorticoids in 21a-hydroxylase deficiency?
|
-HYPOtension
-HYPOnatremia -HYPERkalemia |
|
|
What does the lack of sodium and bp cause?
|
Activation of the Renin system, salt wasting, and volume depletion
|
|
|
What can this severe salt wasting in neonates actually lead to?
|
Hypovolemic shock in a newborn infant!
|
|
|
What WON'T get made and what WILL get made in 11-B-hydroxylase deficiency?
|
WON'T: Corticosterone, Aldosterone or Cortisol
WILL: 11-deoxycorticosterone, 11-deoxycortisol, and Androgens |
|
|
What are the symptoms of 11B-hydroxylase deficiency?
|
HYPERTENSION!!!
Masculinization |
|
|
Why on earth does lack of Aldosterone cause HYPERtension?
|
11-deoxycorticosterone has mineralocorticoid effects; when it builds up it actually causes hypertension.
|
