Term
| Adrenocortical Organogenesis |
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Definition
Condensation of Ventral Intermediate Mesoderm Forms the Urogenital Ridge
adrenogonadal primordium |
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Term
| what's made in the glomerulosa, fasciculata, reticulosa and medulla? |
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Definition
G - aldosterone
F - cortisol
R - testosterone and estrogen
M - Tyr -> Dopa -> dopamine -> NE -> E |
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Term
| QUIZ: steroids and catecholamines have what function at the cellular level? |
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Definition
Steroids – ligands for transcription factors! LIGAND dependent
Catechs – bind to membrane rec similar to peptides… |
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Term
| T/F: teh adrenal medulla secretes more E than the Locus coeruleus |
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Definition
| True: the LC only secretes NE though.... |
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Term
| Too much POMC transcription produces ACTH and MSH and what other relevant stress hormone? |
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Definition
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Term
| T/F: ACTH causes the direct secretion of cortisol |
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Definition
| F: ACTH activates Steroidogenic Enzyme Expression |
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Term
| Where is Corticosteroid Binding Globulin (CBG) produced? |
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Definition
Acidic glycoprotein MW 52,000
Produced in liver, lung, kidney, testes
Regulates delivery of cortisol to tissues |
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Term
| If you have too much cortisol why is it that you get centrally obese? |
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Definition
Build fat centrally, break down protein distally…makes you CENTRALLY OBESE!
GCCs cause redistribution of fat |
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Term
| T/F: GCCs promote the inflammmatory response |
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Definition
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Term
Rank the following in order of antiinflamm/Na-retaining potency, mixed, and equal
cortisol, prednisone, 9alphafluorocortisone, dexamethasone |
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Definition
Dex - pure GCC agonist so only antiinfalmm
Prednisone and 9FC are mixed but predneisone has more antiinflamm fx but is weaker. 9FC has more Naretaining potency than any others.
Cortisol is 1:1 just meant for baseline regulation and short duration |
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Term
| QUIZ: complications in prolonged CCS therapy are (4)? |
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Definition
Osteoporosis*
Diabetes*
Retarded longitudinal growth in children*
Adrenal suppression* |
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Term
| T/F: One can recover endogenous cortisol secretion post withdrawal of exogenous steroids within 9 months |
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Definition
F: You get ATROPHY! Can take up to 18 mos to activate again!
Ability to do this is predicated on adrenal disease…need to slowly taper off…less exogenous wake up more! |
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Term
| Other bad effects of excess GCCs? |
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Definition
| diabetes, brittle bones, psychosis, ulcers... |
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Term
| Why do salmon die when they spawn |
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Definition
– skin color, fat pad, they die of CUSHING’s disease!
Cortisol can bind to min/gcc…aldost – min…body brekas down cortisol to cortisone but doesn’t do that during stress…if there is so much => hypertensive. When salmon go to freshwater they crank up cortisol levels…die of cushing’s! |
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Term
| You diagnose someone w/ tertiary adrenal insufficiency. what's their presenting symptom? |
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Definition
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Term
| QUIZ: in what adrenal insuff is aldosterone decreased? |
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Definition
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Term
| Name some causes of primary adrenal insufficiency |
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Definition
| AI adrenalitis, adrenal TB, hemorrhage |
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Term
| QUIZ: Your patient has hyperpigmentation, proximal muscle weakness, and orthostatic hypotension. Does she have a pituitary adenoma, filled sella, hypofunctioning hypothalamus, or an autoimmune adrenalitis? |
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Definition
must be primary
autoimmune adrenalitis |
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Term
| electrolyte abnormalities in aldosterone deficiency? |
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Definition
low Na, high K, normal Cl
low HCO3, low glucose |
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