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36 Cards in this Set
- Front
- Back
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The adrenal medulla produces __ and the cortex produces __.
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AM - epinephrine. AC - steroid hormones.
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__ is a glucocorticoid involved in metabolism and anti-inflammation.
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Cortisol.
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__ is a mineralocorticoid involved in salt and water balance.
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Aldosterone.
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What three disorders can be caused by excess ACS secretion?
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GC excess - Cushing’s syndrome. MC excess - Conn’s syndrome. Androgen excess - masculinization or feminization.
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What disorder can be caused by insufficient ACS secretion?
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Addison’s dz.
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__ is the starting point for ACS synthesis.
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Cholesterol.
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What is the rate-limiting step in ACS biosynthesis?
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Conversion of cholesterol to pregnenolone.
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Where is the corticosteroid reservoir in the body?
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In the blood.
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Describe the rate of cortisol secretion.
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It follows circadian rhythms controlled by ACTH, which is higher in the morning.
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How is cortisol metabolized?
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Oxidation in the liver.
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How do steroids act on cells?
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Bind to receptor; complex is moved to nucleus.
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How do steroids produce changes in so many different types of cells?
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It acts at the level of gene transcription.
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What are the three models of ACS regulation?
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Diurnal rhythm, ACS negative feedback, and increased steroidogenesis in response to stress.
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__ inhibition of ACTH release in the most clinically relevant. How is this release often suppressed?
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Feedback inhibition. Suppressed by steroid treatment.
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Describe the diagnostic test for adrenal insufficiency.
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Administration of ACTH that should cause rapid rise in plasma cortisol.
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What are the three ways that ACTH increases ACS synthesis?
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Stimulates cells in the fasciculata and reticularis, increases cholesterol transport, and increases conversion of cholesterol into pregnenolone.
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ACTH has a permissive effect on __ production and is the primary regulatory of __ production.
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Permissive to aldosterone production. Regulator of cortisol production.
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__ is a steroid commonly used when GC activity and some MC activity is needed. What disease fits this description?
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Prednisone. Addison’s disease.
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Prednisone is metabolically activated to __.
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Prednisolone.
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Epi, NE, and DA are decreased in the absence of __.
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GC.
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What effect does cortisol have on sugar?
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Stimulates liver to produce sugar and inhibits other cells from taking it up.
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How does cortisol affect inflammation?
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It blocks all steps in the inflammatory process.
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What effect does cortisol have on proteins?
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Stimulates protein breakdown everywhere, except liver, and stimulates amino acid conversion to glucose.
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How does cortisol cause the most obvious feature of Cushing’s syndrome?
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Cortisol causes lipid mobilization and fat redistribution.
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What causes Addison’s disease? What should you assume about this disease?
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Insufficient production of ACTH. Assume GC and MC activities are deficient and must be replaced.
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Why is steroid excess so incredibly dangerous?
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It can cause pathology without any symptoms.
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Corticosteroids attempt to treat __ and minimize __.
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Treat target tissue and minimize systemic absorption.
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There are two more potent anti-inflammatory corticosteroids use. Which one of them inhibits ACTH release?
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Betamethasone and dexamethasone - inhibits ACTH release.
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Give three examples of corticosteroids used as topical anti-inflammatory agents.
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Beclomethasone, flunisolide, mometasone.
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Use one of these two corticosteroids to supplement patient with adrenal suppression.
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Hydrocortisone or prednisone.
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__ is an anti-fungal and non-selective steroid synthesis inhibitor.
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Ketoconazole.
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__ antagonizes progesterone, GC, and sex steroids. Can promote spontaneous abortion with or without misoprotol.
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RU-486 “mifepristone”.
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__ is a PG analog used with mifepristone to cause spontaneous abortion.
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Misoprostol.
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__ is the most commonly used MC and is synthetic.
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Fludrocortisone.
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How do MCs promote fluid and Na reabsorption? This happens at what cost?
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Increased apical Na channels in distal tubule. Occurs at the cost of K.
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__ and __ are MC antagonists that compete for aldosterone receptors.
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Sprinolactone and eplerenone.
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