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Terms in this set (19)
Actions of glucocorticoids? (BAVIC-GG!)
Vascular responsiveness to catecholamines is maintained
Immune response INHIBITION
CNS-effects (decrease REM-sleep, increase slow-wave sleep, increase awake time)
GFR INCREASE (vasodilation of afferent arteriole)
Gluconeogenesis STIMULATION (effects are overall catabolic and diabetogenic).
Actions of mineralocorticoids?
1. Increase Na+ reabsorption
2. Increase K+ secretion
3. Increase H+ secretion
Symptoms of aldosterone-secreting tumor?
ECF volume expansion
Is equal for cortisol and aldosterone.
This problem is solved by 11B-hydroxysteroid dehydrogenase (of the renal cells) which converts cortisol to corisone - cortisol is effectively inactivated in mineralocorticoid target tissues.
Actions of adrenal androgens?
Development of pubic and axillary hair
(They have testosterone-like effects)
High levels of DHEA and androstenedione lead to masculinization in females and increased urinary levels of 17-ketosteroids.
Primary adrenocortical insufficiency commonly caused by autoimmune destruction of all zones of the adrenal cortex.
There will be a HIGH [ACTH] - low levels of cortisol cause an increase in ACTH secretion by negative feedback.
Will hyperpigmentation of skin occur in Addison patients?
Yes! Hyperpigmentation of skin occurs because of an increased level of ACTH which contains a-MSH.
Secondary adrenocortical insufficiency
Insufficient ACTH resulting from failure of corticotrophs in the AP to secrete ACTH.
Distinctions between primary and secondary adrenocortical insufficiency.
1. [ACTH] (primary = high; secondary = low)
2. [Aldosterone] (primary = low; secondary = normal)
3. Hyperpigmentation (primary = present; secondary = not present)
Spontaneous, chronic excess of glucocorticoids
Characterized by excess glucocorticoids, in which the cause is hypersecretion of ACTH from a pituitary adenoma.
Unexpected causes of cortisol excess in Cushing disease?
Hypertension (cortisol has weak mineralocorticoid activity and also increases the responsiveness of arterioles to catecholamines by up-regulating a1-receptors).
How to distinguish between Cushing syndrome and Cushing disease?
Circulating levels of ACTH.
Cushing syndrome = Low levels of ACTH
Cushing disease = High levels of ACTH
Treatment of Cushing syndrome
Treatment of Cushing disease
Surgical removal of ACTH-secreting tumor
Conn syndrome (Primary hyperaldosteronism)
Caused by an aldosterone-secreting tumor.
Circulating [renin] is decreased because of increased ECF volume increasing renal perfusion pressure, which inhibits renin secretion.
Adrenal cortex does not synthesize mineralocorticoids OR glucocorticoids.
Huge increase in production of adrenal androgens, DHEA and androstenedione.
Neither glucocorticoids nor adrenal androgens are produced.
Overproduction of 11-DOC and corticosterone.
Aldosterone levels are decreased (RAA-system)
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