Exam 3 Adrenal Hormones

What is the outer layer of the adrenal cortex called?
Cortex
What is the inner layer of the adrenal cortex called?
Medulla
Where are the adrenal glands located?
On top of each kidney
List the 3 hormones associated with the Medulla
Epinephrine
Norepinephrine
Dopamine
List the 3-4 hormones associated with the cortex
Mineralocorticoids/Aldosterone
Glucocorticoids/Cortisol
DHEAS/Androgens (Testosterone & Estriol)
What is another name for:
Mineralocorticoids
Aldosterone
What is another name for:
Glucocorticoids
Cortisol
The adrenal cortex produces steroid hormones from what type of precursor?
Cholesterol
Aldosterone is controlled by what system?
RAA System (RAS)
Aldosterone is controlled in response to decreased levels of what?
BP or Blood Volume
What is associated with the following:
BP, Na & K regulation
Aldosterone
What is associated with the following:
Glucose, fat, & protein regulation
Cortisol
What is associated with the following:
DHEAS, Testosterone
Androgens
What is critical for Na, K, Acid-Base Balance, & BP
Aldosterone
What is the cause of Primary HYPERaldosteronism?
Adrenal tumors
What is the cause of Secondary HYPERaldosteronism?
Defects in RAA System
In Hypertension, what chemical element is Increased?
Sodium
In Hypokalemia, what 2 chemical elements are Decreased?
Potassium
Hydrogen
What disorder are the following symptoms associated with:
Fatigue, muscle weakness, metabolic alkalosis
Hypokalemia
What does Too much DHEAS in kids lead to?
Precocious puberty, hair growth, and early development of secondary male sex characteristics in boys
What does Too much DHEAS in women lead to?
Hirsuitism, acne, male pattern baldness, amenorrhea, masculine traits
What does Too much DHEAS in men lead to?
Infertility
Feminizing affects
What are 2 causes of Too much DHEAS in women?
Endocrine Disease
Anabolic steroid use
True or False:
DHEAS is NOT controlled by ACTH
True
True or False:
Cortisol is regulated in response to ACTH from Anterior Pituitary
True
What does Cortisol increase?
Fat and protein breakdown
What hormone is critical to glucose metabolism?
Cortisol
What does Cortisol control?
Sodium, water, and other electrolytes
BP
What does Cortisol suppress?
Inflammatory and allergic reactions
During times of _____, Cortisol has an effect on heart function
Stress
When is Cortisol Highest?
8 a.m.
When is Cortisol Lowest?
8-10 p.m.
What Disease is associated with HYPOcortisolism?
Addison’s Disease
What Disease is associated with HYPERcortisolism?
Cushing’s Syndrome
What is Addison’s Disease / HYPOcortisolism usually due to?
Destruction of gland
The following are consistent with which disease:
Autoimmune, TB, HIV, or fungi
Addison’s Disease
HYPOcortisolism – Low Sodium and Low Glucose = ?
Weakness, fatigue, weight loss
HYPOcortisolism will have low amounts of what?
Sodium
Glucose
HYPOcortisolism will have high amounts of what?
Potassium
ACTH
Is skin pigmentation associated with HYPOcortisolism / Addison’s Disease?
Yes
HYPERcortisolism – what will cause the following:
Increased Cortisol
Decreased ACTH
Cortisol-Secreting tumor in the adrenal gland
HYPERcortisolism – what will cause the following:
Increased Cortisol
Increased ACTH
ACTH-Secreting tumor in the pituitary
Is the following considered primary or secondary:
Cortisol-Secreting tumor in the adrenal gland
Primary
Is the following considered primary or secondary:
ACTH-Secreting tumor in the pituitary
Secondary
Is the following considered primary or secondary:
Prolonged steroid use
Secondary
True or False:
HYPERcortisolism alters resistance to stress and inflammation
True
True or False:
HYPERcortisolism slows wound healing; inhibiting antibodies
True
What does HYPERcortisolism Increase in the blood?
fatty acids
blood sugar
What does HYPERcortisolism Decrease?
Calcium Absorption
True or False:
With HYPERcortisolism, no diurnal variation is seen
True
What does Increased Fatty Acids in the blood lead to?
Trunk obesity
Moon face
Buffalo Hump
What does Increased Blood Sugar lead to?
Obesity
Hyperglycemia
Polydipsia
Glycosuria
What does Decreased Calcium Absorption lead to?
Osteoporosis
What is the following associated with:
Thinning skin with discoloration, striae, and bruising
HYPERcortisolism
What are 2 tests that you can run for HYPERcortisolism?
ACH Levels
24 Hour Urine Cortisol
Define “The Full Monty”
Over-production of all adrenal cortex hormones
The following are consistent with too much what?
Hyperglycemia
Moon Face
Buffalo Hump
Central Obesity
Cortisol
The following are consistent with too much what?
Dehydration
Thirst
Increased Sodium
Increased BP
Aldosterone
The following are consistent with too much what?
Amenorrhea & Hirsuitism in women
Muscular hypertrophy in young kids
Infertility in males
Androgens
As Sodium Rises, with too much aldosterone, what happens to Potassium?
Falls
As Sodium Rises and Potassium falls, with too much aldosterone, what happens?
Muscle Weakness
What controls the Adrenal Medulla?
Nervous system
Body’s response to stress, emotion, physical activity, and low glucose levels
What does the Adrenal Medulla produce?
Catecholamines
What are the 3 Catecholamines produced in the Adrenal Medulla?
Dopamine
Norepinephrine
Epinephrine
What does Norepinephrine cause in response to a decrease in BP?
Vasoconstriction of small vessels
Norepinephrine causes Vasoconstriction of small vessels in response to a Decrease in what?
Blood Pressure
Norepinephrine causes Vasoconstriction of small vessels in response to a Decrease or Increase in Blood Pressure?
Decrease
Epinephrine mobilizes energy stores to do what?
Raise Blood Glucose Levels
What does Epinephrine Increase?
Heart Rate
Respiration
What is secreted in HIGH levels during stress or fear?
Epinephrine
What is considered the “Fight or Flight” Hormone?
Epinephrine
What type of production does Epinephrine have?
RAPID
20 seconds
What type of effect does Epinephrine have?
Only lasts 1-2 minutes
Hyperactivity of catecholamines may be caused by what?
Emotions/Stress
Drugs
Food
Tumors
Dopamine –> Norepinephrine –> Epinephrine –> Metanephrine –> ?
Vanillylmandelic Acid (VMA)
Dopamine –> Norepinephrine –> Normetanephrine –> ?
Vanillylmandelic Acid (VMA)
Define Pheochromocytoma
Catecholamine producing tumor
What lab tests do you perform on Pheochromocytoma?
Urinary Metanephrines
VMA
True or False:
Pheochromocytoma – Measuring serum catecholamines is LESS reliable due to short half-life and because levels will be NORMAL between spells
True
“Spells” of what are associated with Pheochromocytoma?
Hypertension
Headache
Dizziness
Pallor
Sweating
Abdominal Pain
List the hormones made in the adrenal cortex:
cortisol, aldosterone, androgens
List the hormones made in the adrenal medulla:
catecholamines (dopamine, epinephrine, norepi.)
Name the precursor substance for ALL the adrenal cortex hormones.
Cholesterol
What primary mechanism controls aldosterone production?
RAA System
what substance does RAA cause to be absorbed in the tubules?
Sodium Reabsoption
At what time of day are cortisol levels highest?
AM
At what time of day are cortisol levels lowest?
PM
What hormone is the primary regulator of cortisol?
ACTH from the pituitary gland
List three causes of Cushing’s syndrome.
Adrenal tumor (primary)
Pituitary tumor (secondary)
Excess cortisol administration (secondary)
Indicate if the following results will be Increased, Decreased, or Normal in Cushing’s:
Na:
K:
Glucose:
Calcium:
Fatty Acids:
Sodium: high
Potassium: low
Glucose: high
Calcium: low
Fatty acids: high
What is the result of excess androgens in women?
Amenorrhea, hirsuitism, virilization
List the catecholamines produced by the adrenal medulla
Dopamine, epinephrine, norepinephrine
Which hormone from the medulla serves to raise BP, respiration, and blood sugar?
Epinephrine
List the catecholamine metabolites that are most frequently tested for in urine
VMA
Name the type of tumor associated with catecholamine excesses
Pheochromacytoma