adrenal glands

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Questions and Answers

the target of aldosterone is the ____ cells in the DCT & collecting duct and the ____ cells in the collecting duct

principle, intercalated

Order the steps of aldosterone changing gene transcription

Lipid solubility → diffusion = Step 1 Binds to cytoplasmic mineralocorticoid receptor = Step 2 Aldosterone-receptor complex → nucleus → DNA → mRNA→ protein = Step 3 --> transepithelial Na+ transport = Step 4

non-genomic effects of aldosterone are faster and involve activation of ____ system (e.g. incr H+ secretion and bicarbonate retention on the intercalated cells of the collecting duct)

second messenger

____ has the opposite effect of aldosterone

<p>ANP</p> Signup and view all the answers

Excess aldosterone leads to metabolic ____.

<p>alkalosis</p> Signup and view all the answers

Both hyperkalemia and angiotensin II lead to ____ secretion.

<p>aldosterone</p> Signup and view all the answers

In the distal collecting duct of the kidney, Aldosterone _______ the reabsorption of Na+, _____ the excretion of K+ , and ______ the secretion of H+, leading to an increase in blood pressure.

<p>↑,↑,↑ (A)</p> Signup and view all the answers

With genetic deficiency of 11β-HSD2 activity, ____ may have substantial mineralocorticoid effect

<p>cortisol</p> Signup and view all the answers

Consumption large amounts of licorice and glycyrrhetinic acid can block the activity of ______ leading to a decrease in the conversion of cortisol to cortisone.

<p>11β-hydroxysteroid dehydrogenase type 2 (B)</p> Signup and view all the answers

Cortisol mobilizes amino acids from the ____ tissues --> diminishes the tissue stores of protein and at the same time it incr the liver enzymes required for the hepatic effects

<p>non-hepatic</p> Signup and view all the answers

cortisol stimulates to ____ occur 6-10x faster in order to increase BG

<p>gluconeogenesis</p> Signup and view all the answers

Cortisol effects metabolism by:

<p>all of the above (D)</p> Signup and view all the answers

increased glucocorticoid secretion occurs when increased ACTH stimulated the zona fasciculata during ____ situations

<p>stressful</p> Signup and view all the answers

What is the result of the increased capillary permeability in the inflamed area?

<p>Leakage of large quantities of almost pure plasma out of the capillaries (D)</p> Signup and view all the answers

What occurs over time in the inflamed area that often helps in the healing process?

<p>Ingrowth of fibrous tissue (D)</p> Signup and view all the answers

What effect does cortisol have on the migration of white blood cells into the inflamed area?

<p>It decreases the migration of white blood cells (B)</p> Signup and view all the answers

How does cortisol affect the formation of prostaglandins and leukotrienes?

<p>It decreases the formation of prostaglandins and leukotrienes (A)</p> Signup and view all the answers

What is the effect of cortisol on fever during inflammation?

<p>It decreases fever by decreasing release of interleukin-1 (C)</p> Signup and view all the answers

How does cortisol contribute to the subside of inflammation?

<p>By decreasing tissue reactions that promote inflammation (C)</p> Signup and view all the answers

What are the two basic anti-inflammatory effects of cortisol?

<p>Blocking the early stages of the inflammation process and increasing the rapidity of healing (D)</p> Signup and view all the answers

What is the effect of cortisol on the migration of white blood cells into the inflamed area?

<p>Cortisol inhibits the migration of white blood cells (A)</p> Signup and view all the answers

How does cortisol contribute to the resolution of inflammation?

<p>By reducing the secretion of prostaglandins and leukotrienes (D)</p> Signup and view all the answers

How does cortisol affect the immune response in infectious diseases?

<p>It decreases blood eosinophils and lymphocytes (B)</p> Signup and view all the answers

What is the impact of excess cortisol secretion on red blood cell production?

<p>It leads to polycythemia (A)</p> Signup and view all the answers

How does cortisol contribute to the prevention of shock or death in anaphylaxis?

<p>By blocking the inflammatory response (A)</p> Signup and view all the answers

What characterizes the diurnal rhythm of CRH, ACTH, and cortisol secretion?

<p>High in the early morning and low in the late evening (C)</p> Signup and view all the answers

At which time of day are CRH, ACTH, and cortisol secretion high according to the diurnal rhythm?

<p>Early morning (C)</p> Signup and view all the answers

Cortisol effects inflammation by:

<p>all of the above (D)</p> Signup and view all the answers

Cortisol effects inflammation by binding to the glucocorticoid receptor and stimulation transrepression of anti-inflammatory proteins

<p>True (A)</p> Signup and view all the answers

Adrenal androgens are converted to____ in the testes

<p>testosterone</p> Signup and view all the answers

____ can be caused by autoimmune antibodies that react with several steroidoogenic enzymes (most often 21-hydroxylase), tuberculosis, cancer, fungal infections, adrenal hemorrhage

<p>Addison's Disease</p> Signup and view all the answers

____ adrenal insufficiency is also referred to as Addison's disease

<p>Primary</p> Signup and view all the answers

Secondary adrenal insufficiency is typically caused by the pituitary gland failing to produce sufficient ____

<p>ACTH</p> Signup and view all the answers

Addison's disease leads to hyperpigmentation due to upregulation fo the ____ gene, leading to increased ___ production

<p>POMC, MSH</p> Signup and view all the answers

____ syndrome describes the signs and symptoms associated with prolonged exposure to inappropriately high levels of the hormone cortisol

<p>Cushing's</p> Signup and view all the answers

Primary aldosteronism is also known as ____ syndrome

<p>Conn's</p> Signup and view all the answers

Patients with Cushing’s Syndrome present with all of the following, except:

<p>Impaired fuel mobilization due to primary adrenal insufficiencies (B)</p> Signup and view all the answers

The adrenal medulla composes ~____% of the adrenal mass

<p>10</p> Signup and view all the answers

Most catecholamines circulate in the blood bound to ____ (low affinity)

<p>albumin</p> Signup and view all the answers

the hypothalamus releases ____, which stimulates the anterior pituitary to release ACTH

<p>Corticotropin-releasing factor (CRF) (C)</p> Signup and view all the answers

How much of cortisol is bound by corticosteroid binding globulin (CBG, transcortin) and albumin?

<p>90-95% (D)</p> Signup and view all the answers

How much of aldosterone is bound by corticosteroid binding globulin (CBG, transcortin) and albumin?

<p>60% (C)</p> Signup and view all the answers

Match the following values for aldosterone and cortisol

<p>aldosterone: normal blood concentration (µg/dL) = 0.006 aldosterone: normal secretory rate (mg/day) = 0.15 cortisol: normal blood concentration (µg/dL) = 12 cortisol: normal secretory rate (mg/day) = 15</p> Signup and view all the answers

Aldosterone stimulates the ___ in locations such as the sweat glands, salivary glands, and intestinal epithelial cells to conserve salt when needed

<p>Na+/K+ ATPase (B)</p> Signup and view all the answers

Effects on protein production from aldosterone are not immediate, taking up to ____ min for protein synthesis

<p>45-60 (C)</p> Signup and view all the answers

____ can be caused by autoimmune antibodies that react with several steroidoogenic enzymes (most often 21-hydroxylase), tuberculosis, cancer, fungal infections, adrenal hemorrhage

<p>Addison's disease (A)</p> Signup and view all the answers

Net excess of aldosterone in the serum leads to ___ [Na+] and ____ [K+] in the ECF

<p>increased, decreased (B)</p> Signup and view all the answers

when there is no aldosterone, large amounts of [Na+] are lost in the urine leading to ____ in ECF volume

<p>decrease (C)</p> Signup and view all the answers

Cortisol is ____ as potent as aldosterone when acting as a mineralocorticoid but plasma conc. of cortisol is ____

<p>1/3000, 2000x higher (B)</p> Signup and view all the answers

Which of the following stimulates to occur 6-10x faster in order to increase BG?

<p>cortisol (D)</p> Signup and view all the answers

Catecholamines are amino acid derived hormones synthesized from ____

<p>tyrosine (C)</p> Signup and view all the answers

One cause of Conn's syndrome (primary aldosteronism) can be caused by small tumor of the ____ that secretes large amounts aldosterone

<p>zona glomerulosa (A)</p> Signup and view all the answers

One cause of Conn's syndrome (primary aldosteronism) is hyperplastic adrenal cortices secrete aldosterone rather than ____

<p>cortisol (C)</p> Signup and view all the answers

Chromaffin cells are the principle cell type within the adrenal medulla, which are “modified” postganglionic neurons richly innervated by ____ from the thoracolumbar spinal cord

<p>cholinergic preganglionic neurons (C)</p> Signup and view all the answers

Pheochromocytoma is a tumor of ____ cells

<p>chromaffin (B)</p> Signup and view all the answers

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Study Notes

Aldosterone

  • The target of aldosterone is the principal cells in the distal convoluted tubule (DCT) and collecting duct and the intercalated cells in the collecting duct.
  • Aldosterone changes gene transcription through the following steps:
    • Binding to mineralocorticoid receptor
    • Formation of a complex with heat shock proteins
    • Translocation to the nucleus
    • Binding to specific DNA sequences
    • Activation of gene transcription
  • Non-genomic effects of aldosterone are faster and involve activation of the protein kinase C system.
  • Cortisol has the opposite effect of aldosterone.

Cortisol

  • Cortisol mobilizes amino acids from muscle tissues, diminishing tissue stores of protein and increasing liver enzymes required for hepatic effects.
  • Cortisol stimulates gluconeogenesis to occur 6-10 times faster to increase blood glucose.
  • Cortisol effects metabolism by increasing glucose release from stored glycogen and increasing gluconeogenesis.
  • Increased glucocorticoid secretion occurs when increased ACTH stimulates the zona fasciculata during stress situations.

Inflammation and Immunity

  • Cortisol increases capillary permeability in the inflamed area, leading to an influx of white blood cells and resulting in inflammation.
  • Over time, cortisol helps in the healing process by reducing inflammation.
  • Cortisol inhibits the migration of white blood cells into the inflamed area, reducing inflammation.
  • Cortisol inhibits the formation of prostaglandins and leukotrienes, reducing inflammation.
  • Cortisol reduces fever during inflammation.
  • Cortisol contributes to the subsidence of inflammation.
  • The two basic anti-inflammatory effects of cortisol are:
    • Reducing the formation of prostaglandins and leukotrienes
    • Inhibiting the migration of white blood cells into the inflamed area
  • Cortisol contributes to the resolution of inflammation by reducing inflammation.
  • Cortisol affects the immune response in infectious diseases by reducing inflammation.
  • Excess cortisol secretion impairs red blood cell production.

Diurnal Rhythm and CRH

  • The diurnal rhythm of CRH, ACTH, and cortisol secretion is characterized by high levels in the morning and low levels at night.
  • CRH, ACTH, and cortisol secretion are high in the morning.

Adrenal Glands

  • Adrenal androgens are converted to testosterone in the testes.
  • Addison's disease is caused by autoimmune antibodies that react with several steroidogenic enzymes, tuberculosis, cancer, fungal infections, or adrenal hemorrhage.
  • Secondary adrenal insufficiency is typically caused by the pituitary gland failing to produce sufficient ACTH.
  • Addison's disease leads to hyperpigmentation due to upregulation of the melanocortin 1 receptor gene, leading to increased melanin production.
  • Cushing's syndrome describes the signs and symptoms associated with prolonged exposure to inappropriately high levels of cortisol.
  • Primary aldosteronism is also known as Conn's syndrome.
  • The adrenal medulla composes approximately 10% of the adrenal mass.
  • Most catecholamines circulate in the blood bound to albumin.

Aldosterone and Cortisol Binding

  • 95% of cortisol is bound by corticosteroid binding globulin (CBG, transcortin) and albumin.
  • 30% of aldosterone is bound by corticosteroid binding globulin (CBG, transcortin) and albumin.

Aldosterone Effects

  • Aldosterone stimulates the ENaC channel in locations such as the sweat glands, salivary glands, and intestinal epithelial cells to conserve salt when needed.
  • Effects on protein production from aldosterone are not immediate, taking up to 30 minutes for protein synthesis.
  • Net excess of aldosterone in the serum leads to high [Na+] and low [K+] in the ECF.
  • When there is no aldosterone, large amounts of [Na+] are lost in the urine, leading to decreased ECF volume.
  • Cortisol is 1/100th as potent as aldosterone when acting as a mineralocorticoid, but plasma concentrations of cortisol are higher.

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