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