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What are the two parts of the adrenal glands?
What does the adrenal cortex secrete?
What does the adrenal medulla secrete?
What is the outermost layer of the adrenal cortex? What percentage of the cortex is this layer?
What hormone does the zona glomerulosa secrete?
What is the principal mineralocorticoid?
What is the middle layer of the adrenal cortex? What percentage of the cortex is this layer?
What hormone does the zona fasciculata secrete? This is the principal what?
What is the deepest layer of the adrenal cortex?
What does the zona reticularis secrete?
What is the rate-limiting step in steroid synthesis?
What enhances the synthesis of aldosterone?
Persistently elevated ACTH lead to _______ & _______ overproduction of cortisol and androgens
If patient is given _______ then cortex will atrophy over time.
What does ACTH activate?
All adrenocortical hormones are ____ compounds that are formed from cholesterol?
What accounts for 90% of mineralocorticoid activity?
How long do free plasma levels of aldosterone last?
What is the effect of aldosterone on sodium and potassium?
What can excessive aldosterone lead to?
What happens with a lack of aldosterone?
What is the cellular mechanism of aldosterone action?
What is a direct antagonist of the mineralocorticoid receptor?
What are the regulators of aldosterone secretion?
What happens to aldosterone secretion without ACTH?
What happens to blood volume with increased K+ and decreased Na+?
What can result from circulatory shock?
What is the principal glucocorticoid?
How much cortisol is secreted daily in absence of stress?
When is cortisol highest in the day?
What is the difference between ultradian and circadian rhythms?
What percentage of cortisol is bound to plasma protein?
Where is cortisol-binding globulin synthesized?
What decreases the binding affinity of CBG?
What are the general effects of cortisol?
How does cortisol affect glucose metabolism?
What is gluconeogenesis?
How does cortisol affect protein metabolism?
What is the effect of cortisol on fat metabolism?
What are the stressors that increase glucocorticoid release?
What cytokines stimulate cortisol synthesis?
What is the effect of corticotropin releasing hormone (CRH)?
What is the role of cortisol in inflammation?
How does cortisol affect white blood cells?
What is the effect of cortisol on cytokine production?
What is chemotaxis?
What is phagocytosis?
What are the effects of cortisol?
How does cortisol affect cytokines?
What does cortisol do to interleukin 1?
What is the effect of cortisol on IL-6 and TNFα?
What is the role of COX-2 in inflammation?
What does cortisol reduce the synthesis of?
How does cortisol affect eosinophils and lymphocytes?
What happens to lymphoid tissue under cortisol's influence?
What is the effect of cortisol on T cells?
What is produced more due to cortisol?
How quickly are the effects of cortisol evident?
What does CRF stand for?
Where is POMC synthesized?
What does POMC serve as a precursor for?
What is the role of ACTH?
What kind of feedback does cortisol exert?
What is the significance of serum cortisol levels?
When should serum cortisol levels be measured for accuracy?
What does an ACTH stimulation test determine?
What is the baseline cortisol level expected in an ACTH stimulation test?
How long can recovery from adrenal suppression take?
What is a normal response to a low dose ACTH stimulation test?
What is the normal response to a high dose ACTH stimulation test?
What is hydrocortisone's equivalent oral dose?
What is prednisone's anti-inflammatory potency?
What is the primary secretion of the adrenal medulla?
What is norepinephrine's secretion percentage?
What is the effect duration of catecholamines compared to neurotransmitters?
What happens to catecholamines in circulation?
What are the metabolic pathways for norepinephrine and epinephrine?
What is the urine marker for catecholamine metabolism?
What is the significance of the bibliography provided?
What is the title of the 10th edition of Miller's Anesthesia?
Who are the authors of the 14th edition of Guyton and Hall Textbook of Medicine Physiology?
What is the title of the 8th edition of Stoelting’s publication?
Who authored the 16th edition of Katzung’s Basic and Clinical Pharmacology?
What is the title of the 2020 journal article about a 54-year-old man with sudden cardiac arrest?
Which journal published the article on licorice abuse in 2020?
What is the main focus of Liu et al.'s article published in 2017?
What does Miller et al.'s 2017 article discuss?
What are the major blood vessels listed in the text?
What are the layers of the adrenal gland?
What hormone is produced by the zona glomerulosa?
What hormone is produced by the zona fasciculata?
What are the androgens produced by the adrenal gland?
What is the function of desmolase in hormone synthesis?
What is the product of 17-Hydroxypregnenolone conversion?
What enzyme converts progesterone into 17-Hydroxyprogesterone?
What are the products of 11B-Hydroxylase action?
What is the primary action of aldosterone?
What is the main function of cortisol?
What percentage of inhaled glucocorticoids is typically swallowed?
What is the dose range for inhaled glucocorticoids?
What is the dosage range for the medication per puff?
How often is the medication usually administered?
Flashcards in this deck (104)
-
What are the two parts of the adrenal glands?
- Adrenal cortex
- Adrenal medulla
anatomy adrenal_glands -
What does the adrenal cortex secrete?
- Corticosteroids
endocrinology hormones -
What does the adrenal medulla secrete?
- Catecholamines
endocrinology hormones -
What is the outermost layer of the adrenal cortex? What percentage of the cortex is this layer?
- Zona glomerulosa
- 15%
anatomy adrenal_cortex -
What hormone does the zona glomerulosa secrete?
- Aldosterone
hormones mineralocorticoids -
What is the principal mineralocorticoid?
- Aldosterone
hormones mineralocorticoids -
What is the middle layer of the adrenal cortex? What percentage of the cortex is this layer?
- Zona fasciculata
- 75%
anatomy adrenal_cortex -
What hormone does the zona fasciculata secrete? This is the principal what?
- Cortisol
- Principal glucocorticoid : causes increased glucose
hormones glucocorticoids -
What is the deepest layer of the adrenal cortex?
- Zona reticularis
anatomy adrenal_cortex -
What does the zona reticularis secrete?
- Weak androgens
hormones androgens -
What is the rate-limiting step in steroid synthesis?
- Cholesterol to pregnenolone
biochemistry steroid_synthesis -
What enhances the synthesis of aldosterone?
- Angiotensin II
endocrinology aldosterone -
Persistently elevated ACTH lead to hyperplasia & hypertrophy overproduction of cortisol and androgens
-
If patient is given exogenous steroids then cortex will atrophy over time.
-
What does ACTH activate?
activates cholesterol desmolase in the adrenal cortex and increase the number of adrenocortical cell receptors for LDL
-
All adrenocortical hormones are ____ compounds that are formed from cholesterol?
steroid compounds
-
What accounts for 90% of mineralocorticoid activity?
- Aldosterone
hormones mineralocorticoids -
How long do free plasma levels of aldosterone last?
- 20 minutes
hormones mineralocorticoids -
What is the effect of aldosterone on sodium and potassium?
- Absorption of Na+
- Excretion of K+
hormones aldosterone_effects -
What can excessive aldosterone lead to?
- K+ loss
- Metabolic alkalosis
hormones aldosterone_effects -
What happens with a lack of aldosterone?
- Increased K+
- Cardiac toxicity
hormones aldosterone_effects -
What is the cellular mechanism of aldosterone action?
- Aldosterone binds to mineralocorticoid receptor (MR)
- Complex moves to nucleus to synthesize proteins
hormones aldosterone_mechanism -
What is a direct antagonist of the mineralocorticoid receptor?
- Spironolactone (Aldactone)
hormones aldosterone_antagonists -
What are the regulators of aldosterone secretion?
- Hyperkalemia
- Angiotensin II
- Hypernatremia
- Atrial natriuretic peptide (ANP)
hormones aldosterone_regulation -
What happens to aldosterone secretion without ACTH?
- Falls to ~ half
hormones aldosterone_regulation -
What happens to blood volume with increased K+ and decreased Na+?
Blood volume would fall.
physiology electrolytes -
What can result from circulatory shock?
Death within a few days.
physiology shock -
What is the principal glucocorticoid?
Cortisol (hydrocortisone).
endocrinology hormones -
How much cortisol is secreted daily in absence of stress?
20 to 25 mg.
endocrinology hormones -
When is cortisol highest in the day?
Highest on awakening (~ 8 a.m.).
endocrinology circadian_rhythm -
What is the difference between ultradian and circadian rhythms?
Ultradian rhythms repeat more frequently than daily, circadian rhythms follow a 1-day cycle.
biology rhythms -
What percentage of cortisol is bound to plasma protein?
90 to 95% bound to cortisol-binding globulin (CBG).
endocrinology hormones -
Where is cortisol-binding globulin synthesized?
In the liver.
endocrinology hormones -
What decreases the binding affinity of CBG?
Increased temperature (fever) and elastase from neutrophils.
endocrinology hormones -
What are the general effects of cortisol?
Enhances adrenergic responsiveness, maintains blood glucose, CNS function, & CV function.
endocrinology hormones -
How does cortisol affect glucose metabolism?
Decreases GLUT 4 translocation, leading to insulin resistance and increased blood glucose levels.
endocrinology metabolism -
What is gluconeogenesis?
Formation of glucose from proteins and fats by the liver.
endocrinology metabolism -
How does cortisol affect protein metabolism?
Decreases protein synthesis in nonhepatic cells and increases protein catabolism.
endocrinology metabolism -
What is the effect of cortisol on fat metabolism?
Decreases glucose uptake into fat cells, increases plasma free fatty acids, and promotes lipolysis.
endocrinology metabolism -
What are the stressors that increase glucocorticoid release?
Trauma, infection, intense heat or cold, surgery, debilitating disease, and restraining an animal.
endocrinology stress -
What cytokines stimulate cortisol synthesis?
Pro-inflammatory cytokines: TNF-α, IL-1, and IL-6.
endocrinology cytokines -
What is the effect of corticotropin releasing hormone (CRH)?
Stimulates ACTH and cortisol synthesis.
endocrinology hormones -
What is the role of cortisol in inflammation?
Stabilizes lysosomal membranes and decreases release of inflammatory substances.
endocrinology inflammation -
How does cortisol affect white blood cells?
Decreases chemotaxis and phagocytosis of damaged cells.
endocrinology immunology -
What is the effect of cortisol on cytokine production?
Reduces production and release of cytokines.
endocrinology inflammation -
What is chemotaxis?
Attraction of WBC to areas of inflammation.
biology immunology -
What is phagocytosis?
The process of engulfing damaged cells by WBC.
biology immunology -
What are the effects of cortisol?
Anti-inflammatory effects, including reduced cytokine production.
biology hormones -
How does cortisol affect cytokines?
It decreases production and release of cytokines.
biology immunology -
What does cortisol do to interleukin 1?
It decreases the release of interleukin 1, reducing fever.
biology immunology -
What is the effect of cortisol on IL-6 and TNFα?
Cortisol decreases their release.
biology immunology -
What is the role of COX-2 in inflammation?
Cortisol decreases expression of COX-2, reducing inflammation.
biology immunology -
What does cortisol reduce the synthesis of?
Prostaglandins, leukotrienes, and platelet activating factor.
biology immunology -
How does cortisol affect eosinophils and lymphocytes?
It decreases their numbers.
biology immunology -
What happens to lymphoid tissue under cortisol's influence?
It undergoes atrophy.
biology immunology -
What is the effect of cortisol on T cells?
It suppresses the number of T cells.
biology immunology -
What is produced more due to cortisol?
Red blood cells (RBC).
biology hormones -
How quickly are the effects of cortisol evident?
Within 24 hours.
biology hormones -
What does CRF stand for?
Corticotropin-releasing factor.
biology hormones -
Where is POMC synthesized?
In the anterior pituitary gland.
biology hormones -
What does POMC serve as a precursor for?
Adrenocorticotropic hormone (ACTH).
biology hormones -
What is the role of ACTH?
Activates cholesterol desmolase and releases cortisol.
biology hormones -
What kind of feedback does cortisol exert?
Negative feedback on CRF and ACTH.
biology hormones -
What is the significance of serum cortisol levels?
Random levels are of little value due to daily variation.
biology hormones -
When should serum cortisol levels be measured for accuracy?
Between 7 and 9 a.m. for maximum secretion.
biology hormones -
What does an ACTH stimulation test determine?
Adrenal function.
biology hormones -
What is the baseline cortisol level expected in an ACTH stimulation test?
Approximately 20 mcg/dl.
biology hormones -
How long can recovery from adrenal suppression take?
2 to 12 months for normal HPA axis function.
biology hormones -
What is a normal response to a low dose ACTH stimulation test?
Peak increase of 16 to 20 mcg/dL in 20 to 30 min.
biology hormones -
What is the normal response to a high dose ACTH stimulation test?
Peak increase of 18 to 20 mcg/dL in 30 to 60 min.
biology hormones -
What is hydrocortisone's equivalent oral dose?
20 mg.
pharmacology corticosteroids -
What is prednisone's anti-inflammatory potency?
4 times that of hydrocortisone.
pharmacology corticosteroids -
What is the primary secretion of the adrenal medulla?
Epinephrine (~80%).
biology hormones -
What is norepinephrine's secretion percentage?
~20% unless in pheochromocytoma.
biology hormones -
What is the effect duration of catecholamines compared to neurotransmitters?
Lasts 5 to 10 times longer.
biology hormones -
What happens to catecholamines in circulation?
They may take 1 to 3 minutes to remove.
biology hormones -
What are the metabolic pathways for norepinephrine and epinephrine?
COMT and MAO pathways.
biology hormones -
What is the urine marker for catecholamine metabolism?
Vanillylmandelic Acid.
biology hormones -
What is the significance of the bibliography provided?
It lists key texts for reference on physiology and pharmacology.
reference bibliography -
What is the title of the 10th edition of Miller's Anesthesia?
Miller’s Anesthesia (10th ed)
anesthesia textbook -
Who are the authors of the 14th edition of Guyton and Hall Textbook of Medicine Physiology?
Hall, J., & Hall, M.
physiology textbook -
What is the title of the 8th edition of Stoelting’s publication?
Stoelting’s Anesthesia & Co-Existing Disease (8th ed)
anesthesia textbook -
Who authored the 16th edition of Katzung’s Basic and Clinical Pharmacology?
Vanderah, T.
pharmacology textbook -
What is the title of the 2020 journal article about a 54-year-old man with sudden cardiac arrest?
Case 30-2020: a 54-year-old man with sudden cardiac arrest.
cardiology journal case_study -
Which journal published the article on licorice abuse in 2020?
Therapeutic Advances in Endocrinology and Metabolism
endocrinology journal -
What is the main focus of Liu et al.'s article published in 2017?
Perioperative steroid management approaches based on current evidence.
anesthesia steroids journal -
What does Miller et al.'s 2017 article discuss?
Hypothalamic-pituitary-adrenal function during health, major surgery, and critical illness.
anesthesia hpa_axis journal -
What are the major blood vessels listed in the text?
- Abdominal aorta
- Left renal artery
- Right renal artery
- Left kidney
- Gonadal arteries
- Ureter
anatomy vascular -
What are the layers of the adrenal gland?
- Capsule
- Zona glomerulosa
- Zona fasciculata
- Zona reticularis
- Medulla
anatomy adrenal_gland -
What hormone is produced by the zona glomerulosa?
Mineralocorticoid
hormones adrenal_gland -
What hormone is produced by the zona fasciculata?
Cortisol
hormones adrenal_gland -
What are the androgens produced by the adrenal gland?
- DHEA
- Androstenedione
hormones adrenal_gland -
What is the function of desmolase in hormone synthesis?
Converts cholesterol into pregnenolone.
biochemistry hormone_synthesis -
What is the product of 17-Hydroxypregnenolone conversion?
Progesterone
biochemistry hormone_synthesis -
What enzyme converts progesterone into 17-Hydroxyprogesterone?
21-Hydroxylase
biochemistry hormone_synthesis -
What are the products of 11B-Hydroxylase action?
- Corticosterone
- Cortisol
biochemistry hormone_synthesis -
What is the primary action of aldosterone?
Regulates sodium and potassium levels in the body.
hormones adrenal_gland -
What is the main function of cortisol?
- Gluconeogenesis
- Protein mobilization
- Fat mobilization
- Stabilizes lysosomes
hormones adrenal_gland functions -
What percentage of inhaled glucocorticoids is typically swallowed?
~80-90%
pharmacology glucocorticoids -
What is the dose range for inhaled glucocorticoids?
50 to 250 mcg / puff, usually BID
pharmacology glucocorticoids -
What is the dosage range for the medication per puff?
50 to 250 mcg
dosage medication -
How often is the medication usually administered?
BID (twice a day)
administration medication -
-