Endocrine2- Adrenal Part 1

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Endocrine2- Adrenal Part 1
2015-10-03 15:48:17
vetmed endocrine2

vetmed endocrine exam 2
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  1. The adrenal medulla makes ___________.
  2. What are the 3 layers of the adrenal cortex?
    zona glomerulosa, zona fasiculata, zona reticularis
  3. Zona glomerulosa makes ___________ under the influence of __(2)__.
    mineralocorticoid (aldosterone); AngII and K+
  4. Zona fasiculata makes ____________ under the influence of ____________.
    glucocorticoids (cortisol); ACTH
  5. Zona reticularis makes __________ under the influence of __(2)__.
    androgens; ACTH, androgen-stimulating hormone
  6. The main mineralocorticoid is __________; it is ______ bound to protein, therefore,...
    aldosterone; 60%; has a shorter half-life than cortisol.
  7. The main glucocorticoid is ___________; it is _________ bound to protein, therefore,...
    cortisol; 95%; has a long half life (slow metabolism)
  8. Adrenocortical hormones are made from __________, which is converted to __________ in the rate limiting step of the conversion.
    cholesterol; pregnenolone
  9. __(2)__ increase production of pregnenolone.
    ACTH and AngII
  10. Adrenal steroids are degraded by the ________; therefore, __________ decreases clearance of steroids.
    liver; liver disease
  11. Cortisol has ___________ activity.
    glucocorticoid (mostly) and mineralocorticoid (some)
  12. Glucocorticoids (2)
    cortisol, corticosterone (ish)
  13. Mineralocorticoids (2)
    aldosterone, cortisol (way ish), corticosterone (ish)
  14. _____________ is the aldosterone precursor.
  15. The dexamethasone dose is _________ of the prednisone dose.
  16. _____________ can be used to stimulate specific glucocorticoid activity, since it does not have mineralocorticoid effects.
  17. Glucocorticoids ___________ gluconeogenesis and __________ blood glucose.
    stimulate; elevate
  18. Glucocorticoids __________ cellular protein and __________ hepatic protein.
    decrease; increase
  19. Glucocorticoids cause __________ of fatty acids.
  20. Cortisol increases gluconeogenesis by... (2)
    increase liver enzymes that convert AA to glucose, mobilize AA from muscle
  21. Glucocorticoids __________ insulin sensitivity in tissues.
    decrease (make DM harder to treat)
  22. Cortisol causes _________ protein synthesis and __________ protein catabolism, causing... (2)
    decreased; increased; muscle weakness, decreased immune tissue function.
  23. Cortisol causes protein to decrease in the _________ but increase in the __________for __________.
    body; liver; gluconeogenesis
  24. Cortisol causes __________ FA mobilization from adipose.
    increases (polyphagia and obesity)
  25. Cortisol prevents _________.
  26. How does cortisol prevent inflammation? (5)
    stabilizes lysosomal membranes, decreased capillary permeability and edema, decreases WBC migration, decreases T cell production, decreases fever (IL-1)
  27. Cortisol causes resolution of inflammation by...
    making resources available for healing.
  28. What effect does cortisol have on the CBC?
    stress leukogram (LEMN- less lymphs and eos, more monos and neuts)
  29. Cortisol decreases intestinal ________ absorption, which may drive up ________.
    Ca2+; PTH
  30. In dogs, cortisol decreases release of ________, causing a _______ side effect.
    ADH; PU/PD
  31. Cortisol is _________ and can/cannot diffuse through membranes.
    lipid-soluble; can
  32. Stress simulation _______ release from the hypothalamus, which stimulates _________ release from the anterior pituitary; this causes the adrenal to release _________, which causes... (4)
    CRH; ACTH;cortisol; gluconeogenesis, protein mobilization, fat mobilization, reduce inflammation
  33. Cortisol has a _______ feedback loop, and...
    negative; reduces CRH and ACTH release.
  34. Physiologic prednisolone dose (Addison's patient).
    0.1/mg/kg/day PO
  35. Anti-inflammatory prednisolone dose.
    0.55mg/kg PO BID
  36. Immunosuppressive prednisolone dose.
    2.2-6.6 mg/kd/day PO
  37. The liver must convert _________ to active form, so give _________ to a patient with liver disease.
    prednisone and cortisone; prednisolone
  38. Aqueous solutions of soluble steroid esters contain __(2)__; they have a ________ onset of action.
    sodium succinate or sodium phosphate ester; rapid
  39. Solutions of free steroid alcohols have ________ onset of action.
  40. Suspensions of insoluble steroid, such as _________, have _________ onset of action.
    Depo-Medrol; slower
  41. Side effects of glucocorticoid therapy. (6)
    GI bleeding/perf, sepsis, iatrogenic cushing's/addison's, insulin resistance, abortion, increased liver enzymes
  42. Glucocorticoids do not interfere with __________; therefore, _________ can be given concurrently.
    antibody formation; vaccines
  43. Glucocorticoids cause GI bleeding because they...
    decrease gastric mucus production, increase gastric acid production
  44. The goal of mineralocorticoids is to... (2)
    deliver O2 and nutrients and remove waste.
  45. How do baroreceptors alter conc of mineralocorticoids?
    detect large increases in BP or blood volume, causing vasodilation, decreased HR, decreased SNS to kidney [w/i seconds]
  46. How do osmoreceptors alter conc of mineralocorticoids?
    in hypothalamus, release of ADH if high osmolality; in macula densa, release renin if Cl- low flow
  47. Juxtaglomerular cells in the __________ make ________, which is cleaved to ______ and released for _____-term volume and pressure control via renal sodium and water control.
    afferent arteriole; prorenin; renin; long
  48. 3 main stimuli for renin release.
    low pressure in afferent arteriole, SNS stimulation of JG cells, decreased NaCl to macula densa
  49. AngII causes __________ constriction, which causes... (4)
    efferent arteriolar; increase pressure in the capillary to enhance GFR, decrease peritubular capillary pressure to enhance fluid reabsorption from the tubules
  50. AngII causes a(n) ________ in BP in order to help with ___________.
    increase; organ perfusion
  51. What effect does AngII have on the kidneys directly?
    increase Na+ and water reabsorption in the proximal tubule
  52. Ang II stimulates _______ secretion.
  53. AngII is one of the main stimuli for secretion of ___________ from the ___________ of the adrenal.
    aldosterone; zona glomerulosa
  54. What cause an increase in aldosterone secretion? (2)
    increase K+ conc, increase in RAAS (AngII)
  55. ________ is necessary for aldosterone secretion.
  56. Mineralocorticoid functions. (3)
    increase sodium and water reabsorption, increase K+ secretion, increase H+ secretion with Na+ reabsorption in intercalated type A cells
  57. Low aldosterone leads to _________.
  58. Mineralocorticoids are _______ soluble; they have receptors in the __(2)__, where they increase... (3)
    lipid; distal and collecting tubules; Na+K+ATPase pumps, luminal Na+ pumps, and luminal K+ pumps
  59. ________ stimulates ANP release, which has an effect on the ________ to _________.
    Atrial stretch (volume overload); collecting duct; decrease Na+ and water reabsorption
  60. What is the new snap test for heart disease in cats?
    test for BNP from ventricles
  61. ADH is released in response to... (2)
    slightly increased blood osmolality, sharply decreased blood volume
  62. ADH functions to __________, causing...
    put aquaporins in the collecting duct; water reabsorption.
  63. What are clinical signs of primary hyperaldosteronism? (4)
    hypokalemia, weakness, cervical ventroflexion, hypertension
  64. Primary hyperaldosteronism can cause ________ due to hypertension.
    retinal detatchment
  65. Primary hyperaldosteronism is caused by... (2)
    benign adrenal tumor or hyperplasia
  66. Primary hyperaldosteronism can look a lot like ___________ clinically.
  67. Diagnose primary hyperaldosteronism by... (3)
    hypokalemia, hypertension, elevated aldosterone or normal aldosterone with hypokalemia
  68. What is the treatment of choice for primary hyperaldosteronism?
    surgery to remove tumor
  69. Describe medical treatment of primary hyperaldosteronism. (3)
    aldosterone antagonists, K+ supplement, antihypertensive medications
  70. In the SNS, catecholamines are _____________; in the adrenal medulla, they are ___________.
    paracrine neurotransmitter; endocrine
  71. Describe the pathway of catecholamine synthesis.
    tyrosine--> DOPA--> dopamine--> norepinephrine--> epinephrine
  72. What enzymes are involves in the synthesis of catecholamines? (3)
    COMT, MAO, aldehyde dehydrogenase
  73. Why is the enzyme MAO clinically important?
    necessary to make catecholamines- many drugs for psychiatric txt target this enzyme
  74. Catecholamines are released in response to...
    SNS stimulation of the adrenal medulla.
  75. Catecholamines bind to ___________ receptors.
    cell surface
  76. Norepinephrine affects ___________; epinephrine affects ____________.
    primarily alpha receptors; alpha and beta receptors equally
  77. Alpha adrenergic receptors cause ____________; beta-adrenergic receptors cause ____________.
    vasoconstriction; vasodilation, cardioacceleration
  78. Effects of NE on the body. (4)
    vasoconstriction, increase HR, inhibition of GI tract, pupil dilation
  79. Effects of epinephrine on the body. (4)
    weaker constriction of blood vessels, greater effect on cardiac stimulation, pupil dilation, decreased GI motility
  80. What are the catecholamines? (2)
  81. Metabolic actions of catecholamines in the liver. (1)
    increase glucose production
  82. Metabolic actions of catecholamines in muscle. (2)
    increased glycogen lysis, decrease glucose uptake
  83. Metabolic actions of catecholamines in the pancreas. (1)
    decreased secretion of insulin and glucagon
  84. Metabolic actions of catecholamines in adipose. (2)
    stimulate lipolysis, reduce glycolysis
  85. Alpha-clocking drugs are used to treat... (2)
    hypertension, urethral spasm
  86. Beta-blocking drugs are used to treat... (2)
    hypertension, to help decrease HR
  87. Alpha-adrenergic agonistic drugs are used to treat... (1)
    urinary incontinence
  88. Beta-adrenergic agonistic drugs are used to treat... (1)
    asthma (causes bronchodilation)
  89. The adrenal cortex derives from the ___________; the adrenal medulla derives from the ____________.
    coelomic mesoderm; neuroectoderm
  90. The adrenal cortex develops from the same embryonic tissue as the ____________; both produce ____________.
    gonad; steroid hormones
  91. What is the only part of the adrenal gland that is required for life?
    zona glomerulosa
  92. Histologically describe the zona fasiculata.
    columns of cubiodal to columnar cells along vascular sinusoids
  93. What is the endocrine control of the zona fasiculata?
    CRH and ACTH
  94. What can you often use to distinguish b/w the zona fasiculata and reticularis?
    fasiculata has more vacuoles that the reticularis
  95. Histologically describe the zona reticularis.
    anastomosing cell cords
  96. What is the endocrine control of the zona reticularis?
    CRH and ACTH
  97. What part of the adrenal makes sex steroids in some species (most vet species)?
    zona reticularis (does NOT in rodents)
  98. _________ are synthesized partially in the mitochondria.
  99. Steroids are __________ molecules that leave cells by __________.
    hydrophobic; diffusion
  100. Smooth ER in the adrenal must be highly functioning because...
    glucocorticoids are not stored, there is constant synthesis; synthesis is ramped up if demand increases
  101. Why does the adrenal lack secretory granules?
    as steroid hormone is produced, it diffuses out of the cell- it is not stored after it is produced
  102. When do glucocorticoid levels peak for animals that are diurnal?
    peak in the morning (evening for nocturnal)... [glucocorticoids play a part in circadian rhythm]
  103. What 2 organelles are required for production of steroid hormones?
    mitochondria and smoothER
  104. In primates,  describe the development of the adrenal cortex?
    cortex undergoes apoptosis and atrophy after birth then regrows
  105. In mice, describe the development of the adrenal cortex?
    cortex undergoes degeneration and atrophy after birth (X-zone)
  106. What causes prolonged gestation?
    fetus doesn't have enough cortisol to initiate parturition
  107. Effect of fetal adrenal cortex on lung maturation.
    surfactant production
  108. Effects enzyme induction by the fetal adrenal cortex. (5)
    fetal gut, retina, pancreas, thyroid gland, brain
  109. The fetal adrenal cortex affects __________ in the liver.
    glycogen deposition