E2: The Adrenal Gland, Morrill

Front 1

The binding of alpha 1 receptors causes ___

Back 1

Vascular and other smooth muscle contraction

Front 2

The binding of beta 1 receptors causes ___

Back 2

Positive inotropic and chronotropic effects on the heart

Front 3

The binding of beta 2 receptors causes ___

Back 3

Vascular, bronchial, and uterine smooth muscle relaxation

Front 4

Symptoms associated w/ pheochromocytomas

Back 4

• Hypertension
• Palpitations
• Chest pain
• Headaches
• Sweating
• Anxiety
• Orthostatic hypotension

Front 5

The building block for all steroids produced by the adrenal cortex

What is the major source of cholesterol for the adrenal cortex?

Back 5

Cholesterol

80% is delivered by LDL’s

Front 6

Initial step of steroid hormone synthesis in the adrenal cortex

Where in the cell does this occur?

Next step?

Where does it occur?

Back 6

Cholesterol to pregnenolone via SCC enzyme (cholesterol desmolase)

Inner mitochondrial membrane

Pregnenolone to progesterone

Smooth ER

Front 7

Enzyme in the zona glomerulosa that helps convert progesterone to aldosterone

Back 7

Aldosterone synthase

Front 8

Enzyme in the zona fasciculate and zona reticularis that helps convert progesterone to cortisol and the androgens

Back 8

17-hydroxylase

Front 9

Two classic alpha antagonists

Back 9

Phenoxybenzamine and phentalamine

Front 10

Treatment for pheochromocytoma

Back 10

Surgical removal and phenoxybenzamine administration

Front 11

Major regulators of aldosterone secretion

Back 11

Angiotensin II and plasma K+

Front 12

How does hyperkalemia stimulate aldosterone secretion?

Back 12

Depolarization of the membranes of the zona glomerulosa cells opens Ca++ channels, stimulating aldosterone production

Front 13

How does cortisol increase blood glucose levels?

Back 13

Decreases insulin sensitivity in muscle and adipose tissue, and stimulates gluconeogenesis

Front 14

Actions and metabolic effects of cortisol

Back 14

• Catabolism of proteins
• Increased lipolysis
• Increased erythropoiesis
• Increased bone resorption
• Inhibited collagen formation
• Increased GFR
• Increased gastric acid and pepsin secretion
• Decreased inflammatory response and cell-mediated immunity
• Increased blood glucose

Front 15

Classification of endocrine disorders by the source of the disorder

Back 15

• Primary: abnormal function of the gland itself
• Secondary: pituitary problem
• Tertiary: hypothalamus

Front 16

The ability of a hormone to produce more than one action by binding to different receptors

Back 16

Cross talk

Front 17

Enzyme present on target cells for aldosterone that converts cortisol to a form which does not bind well to mineralocorticoid receptors

This blunts the mineralocorticoid action of cortisol

Back 17

11 beta-hydroxysteroid dehydrogenase type 2

Front 18

Condition in which both cortisol and aldosterone are low

Back 18

Addison’s disease

Front 19

Major causes of hypoaldosteronism (3)

Major causes of hyperaldosteronism (2)

Back 19

• Autoimmune disease
• TB
• Carcinoma of the adrenal cortex

• Secreting tumor of the adrenal cortex
• Excess rennin secretion

Front 20

Excessive production of aldosterone caused by a tumor in the adrenal cortex

Also referred to as primary hyperaldosteronism

Back 20

Conn’s syndrome

Front 21

Autoimmune distruction of the adrenal cortex

Also referred to as primary adrenocortical insufficiency

Back 21

Addison’s disease

Front 22

Common signs/symptoms of Addison’s disease

Back 22

• Weakness, fatigue, weight loss
• Hyperpigmentation, elevated ACTH
• Hyperkalemia, hyponatremia, hypertension
• Hypoglycemia
• GI problems

Front 23

Congenital condition in which excessive adrenal androgens are producedand secreted due to lack of functioning 21-hydroxylase enzyme

What is the therapy?

Back 23

Adrenogenital syndrome

Administration of cortisol

Front 24

The rate limiting step in the synthesis of catecholamines

Back 24

The first step, tyrosine to DOPA

Front 25

Last step in the synthesis of catecholamines

What hormone induces the enzyme that catalyzes this step?

Back 25

NE to E via phenylethanolamine N-methyltransferase (PNMT)

Cortisol

Front 26

2 enzymes that break down catecholamines

Back 26

COMT and MAO

Front 27

What are the products when catecholamines are O-methylated by COMT?

What product is formed when COMT and MAO act on each other’s products in the breakdown of catecholamines?

Back 27

Metanephrine and normetanephrine

Vanillymandelic acid (VMA)