Adrenal Gland S2M1

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Adrenal Gland S2M1
2011-08-13 10:00:56
Ross S2M1

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  1. The Adrenal medulla is derived from
    Ectoderm (neural crest cells)
  2. Which portion of the Adrenal gland is important to Sympathetic nervous system
    Adrenal medulla
  3. What are the main targets of the Adrenal Catecholamines
    • Cardiovascular system
    • Respiratory system
    • Central Nervous system
    • Liver
  4. What is the reaction in the Liver, Adipose, and Skeletal muscles when Catecholamine are released into the blood stream
    • Increase
    • - Lypolysis
    • - Glycogenolysis
    • - Gluconeogenesis
    • - Glucagon secretion
    • Decrease
    • - Glucose uptake
    • - Insulin secretion
    • (Glucagon effects)
  5. Pheochromocytoma
    • Tumor of the adrenal medulla leading to over production of Catecholamines
    • This places the body in a constant "fight or flight" type condition
    • Headaches and excessive sweating also ensue
  6. What are the effects of Epinephrine on Beta 1 and 2 receptors respectively
    • Beta 1 - Increase heart rate and contraction
    • Beta 2 - Bronchial dilation
  7. What are the major secretions of 3 layers of the Adrenal cortex and what hormone activates each
    • Zona Glomerulosa (Aldosterone) - Renin angiotesin system
    • Zona Fasciculata (Cortisol) - ACTH
    • Zona Reticularis (Androgens) - ACTH
  8. POMC
    A gene in the Ant. Pituitary that encodes for several hormones including corticotropin (ACTH)
  9. What are the different ways that Cortisol is transported in the blood stream
    • Free - 10%
    • Corticosteroid binding globulin - 75%
    • Albumin - 15%
  10. What are the different ways that Aldosterone is transported in the blood stream
    • Free - 40%
    • Corticosteroid binding globulin - 10%
    • Albumin - 50%
  11. What are the different ways DHEA-sulfate is transported in the blood stream
    • Free - 2%
    • Albumin - 98%
  12. What steroid made by the Adrenal cortex is found to have one of the lowest concentrations in the blood stream
    Aldosterone (.002-.010)
  13. What is the most important Mineralocorticoid
    • AldoSterone
    • "Stone=mineral"
  14. What is the most important organ Aldosterone acts on and what is its effect
    • Epithelial cells of the collecting tubule of the kidney
    • Promotes absorption of Na+ and secretion of K+
    • Stimulates H+ secretion
  15. What organs besides the kidneys does Aldosterone act on
    • Salivary glands
    • Sweat glands
    • Colon
    • Causes retention of sodium
  16. Angiotensinogen is released from where and has what effect
    • Liver
    • It is broken down to Angiotesin I and II, which increases the synthesis of Aldosterone in the Adrenal Cortex
  17. What regulates the secretion of Aldosterone (Renin Angiotensin System)
    High sodium and Low potassium shut it off
  18. What effect does Cortisol have on metabolism
    Stimulation of Gluconeogenesis, Glycogenesis, Increase protein Catabolism, and Lipolysis
  19. What is the effect of Glucocorticoids on ACTH, Kidneys, Immune system, Gastric secretion
    • Decrease in ACTH synthesis
    • Increase water excretion
    • Decrease inflammation
    • Increase in gastric secretion
  20. What regulates Glucocorticoid release
    • High Cortisol inhibits Hypothalamus release of CRH as well as the Ant. Pituitary for releasing ACTH
    • Stress increases Hypothalamus release of CRH
    • High ACTH inhibits CRH release
    • Diurnal rhythms activate CRH release from Hypothalamus
  21. What point in the day his Cortisol the highest and why is this significant
    It is highest first thing in the morning after waking up, this is when heart attacks are most frequent
  22. Primary Adrenocortical Hypofunction
    • Addisons disease "Not add but subract function"
    • There is an increase in ACTH but the Adrenal gland isn't making cortisol, this further triggers the release of ACTH
  23. Secondary Adrenalcortical hypofunction
    The Pituitary gland is damage resulting in a decrease in ACTH resulting in low cortisol, CRH would be high
  24. What does the amount of ACTH and Cortisol look like in Cushings disease
    The Pituitary is over producing ACTH causing an increase in Cortisol (secondary hypersecretion)
  25. What do the levels of ACTH and Cortisol look like when there is an adrenal tumor causing hyperfunction
    Cortisol is high from overproduction in the Adrenal cortex, ACTH is low due to the cortisol giving negative feedback to the hypothalamus and pituitary gland
  26. What drugs are used for the treatment of Addisons disease
    • Glucocorticoids (replace Cortisol)
    • Mineralocorticoids (replace Aldosterone)
  27. What drug is used for a patient experiencing an Acute adrenal insufficiency (Addisonian crisis)
    IV administration of Hydrocortisone
  28. Prednisone
    • Intermediate acting glucocorticoid (lasts 12-36 hrs)
    • 4x the ant-inflammatory effects of Hydrocortisone
  29. Dexamethasone
    • Long acting Glucocorticoid (lasts 24-72 hrs)
    • High anti-inflammatory activity (30x more then Hydorcortisone)
  30. What are the side effects of Glucocorticoid therapy
    • Osteoporosis
    • Cataracts
    • Immune suppression
    • Fat redistribution
    • Diabetes
  31. Why can't chronic Glucocorticoid therapy be stopped abruptly
    It could cause an Addisonian crisis
  32. Ketoconazole
    • Drug used for Cushings disease
    • Antifungal agent that inhibits P450 enzymes involved in corticosteroid biosynthesis
    • Inhibits Androgen synthesis
    • Can cause gynecomastia
  33. Mifepristone
    • Glucocorticoid receptor antagonist
    • Progesterone antagonist as well
  34. Spironolactone
    • Mineralocorticoid antagonist
    • Aldosterone-receptor antagonist
    • Slow onset of several days
    • Also inhibits Androgen receptors competing with dihydrotestosterone
  35. Fludrocortisone