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Endocrine, Reproductive, Nervous system & mental health (part 2)
Dr. James Nelson
Terms in this set (37)
How does adreno-pathophysiology disturb development?
-abnormal sexual differentiation (females)
- precocious puberty (males)
too much cortisol causes ___
too little cortisol causes ___
too much= Cushing's
too little = Addison's
CRH (corticotropin releasing hormone) stimulates what?
CRH --> ACTH --> cortisol, aldosterone, adrenal androgens
What is the feedback mechanism for the hypothalamic-pituitary-adrenal axis system?
suppression of cortisol (increases/decreases) ACTH
What are some stimulators of ACTH?
- Cortisol decrease (adrenalectomy, metyrapone)
- sleep-wake transition
- psychiatric disturbance
ACTH follows circadian rhythm, when are cortisol levels highest in the blood naturally?
at hour 6 of sleep
during the day, the cortisol levels are highest at the
The synthesis of hormones from the adrenal gland are separated out by zones. Match the following secretory products with the corresponding zone:
- aldosterone= glomerulosa
- cortisol = fasciculata (largest zone)
- andgrogens = reticularis
- epi/ne = medulla
What are all steroids basic structure?
4 rings surrounded by carbons
steroids are derived from
When first converting cholesterol to a steroid ____ (enzyme) cleaves carbon 21
P450 side chain cleaving enzyme
what is the second precursor to all steroids?
(cholesterol --> pregnenolone)
What enzymes are used to convert cholesterol to Adrenal androgens? (biosynthesis picture)
enzymes: P450 SCC (cholesterol desmolase), 17-alpha hydroxylase & 17,20-lyase
Androgens are __(#) carbon steroids
50% of androgens in females come from where?
adrenal androgens are (weak/strong) androgens, and are prohormones converted into testosterone peripherally
adrenal androgens can also be aromatized into
The blood flow in the adrenal gland travels how?
Glomerulosa down to medulla
What are the enzymes specific to the fasciulata?
21B & 11B hydroxylase
If you have a defect in 21-beta hydroxylase or 11-beta hydroxylase, what happens?
what happens if you have SEVERE deficiency?
androgen overproduction in the reticularis
cortisol & aldosterone deficiency
What are the plasma cortisol binding proteins? How much of circulating cortisol is bound?
-transcortin (corticosteroid binding globulin)
-90-95% of circulating cortisol is bound
___ cortisol is the biologically active (bioavailable) fraction
Where is transcortin synthesized? Does it have high or low affinity?
in the liver // high affinity for cortisol
What are the 2 major functions of transcortin/CBG
1. cortisol reservoir
2. slows metabolism (increased 1/2 life) of cortisol
What are the 2 major characteristics of cortisol?
1. CATABOLIC hormone
2. permissive actions (i.e. facilitates actions of other hormones in important ways)
Hypercortisolemia is associated with which dx? what symptoms will you see?
- muscle wasting
What actions does cortisol potentiate?
- glycogenolysis by glucagon
- gluconeogenesis by glucagon
- tyrosine induction of tyrosine transaminase
how does cortisol act on target tissues?
via intracellular hormone receptor mechanisms (same as thyroid hormone)
all steroid hormones are (lipophilic/ lipophobic)
what is the only other steroid that will also bind to the glucocorticoid receptors?
(and glucocorticoids will bind to the progesterone receptors)
Cortisol alters gene expression via
glucocorticoid receptors (GRs)
How does cortisol mobilize fuels at the following levels of the body:
- brain: stimulates appetite
- fat: breaks down TG into FFA to provide energy for the body
- liver: promotes gluconeogenesis
- muscle: breaks down proteins into AA to go to the liver for gluconeogenesis
In the absence of cortisol, death from fasting occurs much (sooner/later)
Why will you die sooner from fasting in the absence of cortisol?
-w/o cortisol, the body will not break down proteins (proteolysis) or make glucose (gluconeogenesis). So when you run out of glucose, hypoglycemia occurs.
- Additionally, lipolysis by epinephrine, GH, etc is NOT potentiated in the absence of cortisol
cortisol is both an anti-inflammatory AND
How then does cortisol protect against stressors, such as trauma and infection, that require pro-inflammatory & pro-immunological defenses?
Cortisol keeps inflammatory & immune responses in check
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