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18 Cards in this Set

  • Front
  • Back
How is cortisol secreted?
Circadian rhythm, 24 hr
Where is cortisol made in the adrenal cortex?
z. glomerulosa
What is the most common glucocorticoid?
What is the disease with EXCESS cortisol?
Cushing's Syndrome
What are the major causes (in order)? (4)
1) OD of glucocorticoids
2) excesssive secretion of ACTH by pituitary
3) ectopic, non-endocrine, ACTH-secreting tumors
4) tumors of adrenal cortex
What are the clinical features?
1) obesity (with fat in the the trunk ) i.e skinny arms and legs?
2) HTN
3) glucose intolerance
6)purple straie (thin skin with underlying blood vessels
& easy bruisability
7) osteoporosis
8) mental effects
9) acne
What is Addison's Disease?
It is the Primary adrenocortical insufficiency in where there is FAILURE to produce adrenocortical hormones because there is a defect with the adrenal gland.
What are the clinical features of adrenal insufficiency?
1) since no Aldosterone - decreased renal Na+ reabsorption leads to hyponatremia, depletion of sodium and polyuria
2) polyuria leading to decrease in plasma volume, hypotension, and dehydration
3) Hyperkalemia since K+ excretion is reduced
4) Because of cortisol insufficiency - 8 reasons which correspond to the function of cortisol
What hormones are insufficient in adrenal insufficiency?
cortisol, androgens, aldosterone
What are the functions of Cortisol? (8)
1 protection ag. hypoglycemia
2 anti-inflammatory
3 permissive effect on catecholamine-induced lipolysis
4 CNS -affects mood and behavior
5 Immunosuppressive actions
6 Permissive effect on lung development and surfactant
7 works with other hormones: synergistically or permissively
8 action for vasoconstriction and helps to maintain bp
How does cortisol help to protect against hypoglycemia?
1) promote gluconeogenesis via induction of enzymes
2) mobilizes aa for gluconeogenesis by protein catabolism
3) promotes glycogenolysis from the liver
4) blocks glucose uptake by peripheral tissues and decrease sensitivity of skeletal and fat to insulin (so sugar available for brain)
T or F - cortisol has dampening effect on sensory signals
True - one of the CNS effects of cortisol
Describe cortisol's anti-inflammatory action.
1) it stimulates I-kB, the inhibitory protein which keeps NF-kB in the cytoplasm
2) it interferes with transcription factor, NF-kB, from binding to its HRE which helps with the expression of proteins and peptides in the inflammatory response.
TAKE HOME MSG: no expression of inflammatory proteins
What is phospholipase A2 & cyclooxygenase?
key enzymes in the production of inflammation agents fom arachidonic acid
What is NO synthase?
synthesize NO (nitric oxide) which is a vasodilator
How is cortisol regulated (briefly)
by ACTH which is regulated by CRH and VP
What are 2 more ways that cortisol decrease inflammation?
1) induce the synthesis of IL-10 and lipocortin which inhibit phosopholipase A2
2) also inhibit the release of histamine and serotonin from mast cells and proteolytic enzymes from damaged cells and phagocytic cells
Name 3 ways that cortisol supresses the immune system.
1. Decrease circ. quantity of circulating lymphocytes & eosinophils by moving them from blood to the spleen
2. induce apoptosis
3. inhibit cytokine synthesis