Adrenal Pituitary Gland Quiz

Aldosterone is the most potent mineralocorticoid because it plays a crucial role in regulating the balance of water and electrolytes in the body. It acts on the kidneys, promoting the reabsorption of sodium and the excretion of potassium, thereby helping to maintain blood pressure and fluid balance. Deoxycorticosterone is also a mineralocorticoid, but it is less potent than aldosterone. Testosterone, cortisol, and adrenaline are not mineralocorticoids, but rather belong to different classes of hormones with different functions in the body.

The adrenal gland is located on the kidneys. It is an endocrine gland that sits on top of each kidney. It consists of two parts: the adrenal cortex and the adrenal medulla. The adrenal gland produces hormones that regulate various functions in the body, including stress response, metabolism, and blood pressure.

Action potential go to..

-> hypothalamus (neuroendocrine response)
-> somatic sensory cortex (perception/stress)
-> motor cortex (voluntary action response)
-> limbic cortex (emotions)

The arrangement of the cells in the zona glomerulosa is in the form of a whorl. This means that the cells are arranged in a circular or spiral pattern, with each layer of cells overlapping the previous one. This arrangement allows for efficient communication and interaction between the cells, as well as optimal functioning of the zona glomerulosa in producing and secreting hormones.

The arrangement of the zona reticularis is netlike, which means that the cells are arranged in a network-like pattern. This suggests that the cells are interconnected and form a complex structure.

Inhibit ADH release

Binds to cortisol receptors ---> inhibit ADH release ---> increase in free water loss ---> polyuria.

GFR : Glomerulosa, Fasciculata, Reticularis

IgA will decrease.

Epstein-Barr virus will increase. (DAMAGING!)

Dexamethasone is the treatment for Pituitary Cushing's Syndrome. This glucocorticoid medication is commonly used to suppress the production of cortisol, which is elevated in Cushing's Syndrome. By reducing cortisol levels, dexamethasone helps to alleviate the symptoms of the condition. It is important to note that dexamethasone should be used under medical supervision, as it can have side effects and interactions with other medications.

Cushing's Syndrome is a condition characterized by high levels of cortisol in the body. In some cases, it can be caused by an ectopic lesion, which refers to a tumor or abnormal growth outside of the normal location. In this scenario, the ectopic lesion would be producing excessive amounts of ACTH (adrenocorticotropic hormone). ACTH stimulates the adrenal glands to produce cortisol, leading to the high levels observed in Cushing's Syndrome. Therefore, the hormone that will be in high levels in this case is ACTH.

Why?

Dexamethasone acts on Pituitary alone.

No specific plasma carrier protein, forms weak association with albumin.
Due to lack of specific plasma carrier protein, aldosterone is rapidly cleared from plasma by liver (form tetrahydroaldosterone 3-gluocronide) which will be excreted in the urine.

The given clinical features, such as hirsutism, acne, Buffalo hump, moon facies, and abdominal purple striae, are commonly associated with Cushing's syndrome, which is characterized by excessive cortisol production. Cortisol hypersecretion is the correct diagnosis in this case.

The arrangement of the cells in the zona fasciculata is in the form of linear cords. This means that the cells are arranged in long, parallel cords or strands. This arrangement allows for efficient secretion of hormones, such as cortisol, which is produced in the zona fasciculata. The linear cords help to maximize the surface area available for hormone production and release.

Always remember, when there is increase in cortisol, there will be increase in aldosterone but decrease in ADH.

According to the graph, the effect of the cold pressor test on blood pressure and heart rate is an increase. This means that when the hand is immersed in cold water for 3 minutes, both blood pressure and heart rate will rise.

The correct answer is acidic. This is because the loss of K+ ions, which are basic, will cause the blood to have a higher concentration of acidic ions relative to basic ions. This shift in the acid-base balance of the blood will make it more acidic.

* High plasma renin levels – reninoma (not involved in the renin-angiotensin-aldosterone axis)
* High water retention (oedema)
* Renal ischemia (?)

Action potential go to..

-> hypothalamus (neuroendocrine response)
-> somatic sensory cortex (perception/stress)
-> motor cortex (voluntary action response)
-> limbic cortex (emotions)

Glucocorticoids (Cortisol)

Stimulate protein catabolism –> liver uptake of amino acids –> conversion to glucose (gluconeogenesis)
**Anti-insulin action on muscle (own local supply) & adipose tissue (inhibit uptake of glucose)
Increase glucose supply to brain
TG breakdown –> glycerol + FA (fuel for muscle activity)
Increase plasma AA, glucose, glycerol & FA
Permissive effects (gives permission) for:
-Catecholamines (vasoconstriction, bronchodilation, lipolysis)
-Glucagon (gluconeogenesis)
Antiallergic effect
Increase RBC count
Increase neutrophil count
Due to the permissive actions for catecholamines & glucagon, secretion of ACTH & glucocorticoids (cortisol) are essential for survival when stress is severe.

Probably because glucocorticoid will stimulate the hypothalamus. In this case, adrenal cushing's is specifically due to an adrenal cortical lesion.

This is a Iatrogenic Cushing's Syndrome

# Adenomas – slow growing , pure hypercortisolism (only cortisol)
# Carcinomas – larger, more cortisol precursors & adrenal androgens
# Micronodular hyperplasia – rare, common in young adults, autosomal dominant, asso. with pituitary & testicular lesions.

E & NE are catecholamines

Same as ADH. It will increase no. of Na+ channels on the apical membrane. The reabsorption of Na will cause a decreased osmolality in the tubules. hence water will be reabsorbed as well via osmotic pull.

Cushing's syndrome is a hormonal disorder caused by prolonged exposure to high levels of cortisol. Cortisol is a hormone produced by the adrenal glands that helps regulate metabolism and respond to stress. In Cushing's syndrome, the body produces excessive amounts of cortisol, leading to a variety of symptoms such as weight gain, high blood pressure, and muscle weakness. Therefore, the correct answer is "High cortisol."

Hyperaldosteronism is a condition characterized by excessive production of aldosterone hormone by the adrenal glands. It is more commonly seen in adult females compared to other demographics. This may be due to various factors such as hormonal changes, pregnancy, and certain medical conditions that affect the adrenal glands. Therefore, adult females are more prone to developing hyperaldosteronism compared to other age groups or genders.

Develop beard
Masculine pattern of body hair distribution
Clitoris grows to resemble small penis
Also linked to Polycystic Ovarian Syndrome (another post)

Receptors:

Nocireceptor: pain
Thermo: temperature
Mechano: physical
Baro: blood pressure
Chemo: glucose, acid, O2
In Special senses: sight, smell

Alarm state/Compensation phase:

When the stressor is noticed, there will be onset of shock and decreased resistance.
During this time, both sympatho-adrenal & hypothalamo-pituitary-adrenocortical axis are activated.
Resistance phase:

Resistance to the stressor increased as animal adapted & coped with it
Lasts for as long as the animal can support this heightened resistance.
Exhaustion/Decompensation phase:

Resistance has exhausted

Overactivity of pituitary alone is not enough to cause Cushing's, as it is not specific and constant in duration and volume.

Aldosteronism refers to the excessive secretion of aldosterone hormone. Hypernatremia is a condition characterized by high levels of sodium in the blood, which can occur due to aldosteronism. Hypokalemia is a condition where there is a low level of potassium in the blood, which can also be caused by aldosteronism. Alkalosis refers to an imbalance in the body's pH levels, causing it to become more alkaline, and aldosteronism can contribute to this condition as well. Therefore, hypernatremia, hypokalemia, and alkalosis are all signs and symptoms associated with aldosteronism.

Both secrete glucocorticoids & androgens

Plasma binding protein : α-globulin/ transcortin/corticosteroid-binding globulin (CBG) produced in the liver (increased synthesis by estrogens)
Only small amounts bound to albumin (weak association)
Unbound: 8% of total cortisol (biologically active)

Noradrenalin & Adrenaline

equally potent in increasing alertness (adrenaline evokes more anxiety & fear)
Known familiar stress –> more Noradrenaline
Unknown stress – > more Adrenaline

Prolonged stress can have various effects on health, including cardiovascular disease. This is because stress can lead to elevated blood pressure, increased heart rate, and inflammation, which can contribute to the development of cardiovascular problems. Additionally, prolonged stress can result in the release of glucocorticoids in large amounts, which can suppress the immune system. This can make individuals more susceptible to infections and diseases. Furthermore, excessive glucocorticoids can also increase protein catabolism, leading to muscle loss.

Adrenal Cushing's is not indfluenced by hormonal stimulation of ACTH/CRH. If ACTH level is high, it is known as Pituitary Cushing's Syndrome.

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The adrenal cortex is responsible for the biosynthesis of steroid hormones. These hormones are derived from cholesterol, which is a type of lipid. Therefore, the adrenal cortex contains cells with large amounts of lipid to support the production of steroid hormones. Additionally, the smooth endoplasmic reticulum (SER) plays a crucial role in the synthesis of lipids, including cholesterol. Hence, the presence of SER in the adrenal cortex is essential for the biosynthesis of steroid hormones.

persistent hyperglycemia (high glucose)
loss in muscle & bone protein
water & salt retention (hypertension, oedema) – aldosterone action
swollen ‘moon’ face
buffalo hump
tendency to bruising
poor wound gealing
enhanced anti-inflammatory effects (lack of inflammatory cells)
polyuria, polydipsia – Low ADH
striae
pendulous abdomen

Small cell carcinoma of the lungs is the most prominent ectopic lesion in ACTH-dependent Cushing's disease. This is because small cell carcinoma of the lungs can produce ACTH, leading to an overproduction of cortisol and the development of Cushing's disease. Bilateral adrenal cortex carcinoma and pancreatic carcinoma can also cause Cushing's disease, but small cell carcinoma of the lungs is the most common and well-known cause of ectopic ACTH production in this condition.

Retention of Na+ due to antidiuretic effect of aldosterone?

Will also cause Hypokalemia which will present as muscle weakness and cardiac arrhythmia

It does not only act on kidney tubules for Na+ reabsorption, but also on blood vessels (perspiration), tongue (saliva) and stomach (gastric juice).

Aldosterone is needed to conserve Na & eliminate K.

Stress will cause release of corticotropin releasing hormone (CRH) from hypothalamus ----> Adrenocorticotropin (ACTH) from anterior pituitary ----> act on adrenal gland ----> produce aldosterone.

Aldosterone release will cause increase in blood volume & BP, ensuring adequate delivery of O2/CO2 and nutrients during stressful period.

Androsterotenedione and DHEA are precursors to the sex hormones. Androsterotenedione is converted into testosterone and estrogen, while DHEA is converted into testosterone and other androgen hormones. These precursors play a crucial role in the synthesis of sex hormones in both males and females. DHAP and DHT are not precursors to sex hormones and do not have a direct role in their synthesis.

DHT (dihydrotestosterone) and testosterone are active androgens. Androgens are male sex hormones responsible for the development and maintenance of male characteristics. DHT is a potent androgen that is derived from testosterone and plays a crucial role in male sexual development and function. Testosterone is the primary male sex hormone and is responsible for the development of male reproductive tissues and secondary sexual characteristics. Progesterone, DHEA, and estrogen are not active androgens. Progesterone is a female sex hormone, while DHEA and estrogen are primarily involved in female reproductive processes.

The adrenal cortex mainly secretes corticosteroids of the C19 and C21 types. These include hormones such as cortisol, aldosterone, and corticosterone. These corticosteroids play important roles in regulating various physiological processes in the body, including metabolism, immune response, and electrolyte balance.

In Cytoplasm, Cholesterol + Acetate = Cheolesteryl esters stored in storage vacuoles.

Cholesteryl esters ---b/d---> Fatty acid + Cholesterol

1st step : Cholesterol enter mitochondrion –--enzyme desmolase/ SCC---> convert to Pregnenolone (RATE LIMITING STEP)

2nd step : Pregnenolone enters cytoplasm ---enzyme dehydrogenase, isomerase ---> Progesterone ----> Enter Endoplasmic reticulum

3rd step : Progesterone --- enzyme hydroxylase ---> 17 a- hydroxyprogesterone

4th step : 17a-hydroxyprogesterone --- enzyme hydroxylase ---> 11-Deoxycortisol

5th step : 11-Deoxycortisol enters mitochondrion --- enzyme hydroxylase ---> Cortisol ----> Enter cytoplasm

Post-menopausal women experience a decline in estrogen production due to the regression of the ovaries. However, the body tries to compensate for this lack of estrogen by converting androgens into estrogens. Androgens, which are male sex hormones, can be converted into estrogens in post-menopausal women, thus serving as important precursors for estrogen production. Therefore, androgens are important precursors of estrogens for post-menopausal women.

Pregnancy can be considered a physiological stressor because it causes significant changes in a woman's body, such as hormonal fluctuations, increased blood volume, and weight gain. These changes can put physical stress on the body, leading to various physiological responses. Additionally, pregnancy also involves emotional and psychological stress due to the anticipation of childbirth and the responsibilities of becoming a parent. Therefore, pregnancy can be considered a physiological stressor.