Endocrine Friday, Wk 2

Angiotensin II binds to what cells?

glomerulosa cells

Glomerulosa cells in the zona glomerulosa releases?

aldosterone

AKA for Cushing's Syndrome

hypercortisolism

Adrenocorticotropic hormone (ACTH) binds to what cells?

fasciculata cells

Fasciculata cells release what?

cortisol

CRH is released in response to what?

stress and low blood levels of cortisol

Where is Hypothalamic CRH released from?

parvocellular neurons

Where are parvocellular neurons located?

paraventricular nucleus

CRH travels to the _________ in order to get to the anterior pituitary gland.

hypophyseal portal system

What are the target cells of CRH?

corticotroph cells

Corticotroph cells stimulate the release of what hormone?

ACTH

ACTH stimulates the release of what hormone?

cortisol

What zone of the adrenal gland releases cortisol?

zona fasciculata

Androstenedione can be converted into what?

estrogen or testosterone

In biological females who suffer ACTH dependent Cushing's syndrome, unique (female only) features are...

hirsutism

menstrual cycle abnormalities

high levels of testosterone

What is the number 1 cause of Cushing's Syndrome?

cushings disease

What are the 2 main concerns of high cortisol levels?

hypertension

hyperglycemia

Two categories of Cushing's syndrome

ACTH-dependent causes

ACTH-independent causes

ACTH-dependent causes of Cushing's syndrome is due to what?

overproduction adrenocorticotropic hormone (ACTH)

T/F: There are issues in the adrenal gland in ACTH-dependent Cushing's Syndrome.

F

What causes the overproduction of ACTH?

1. Cushing's disease

2. Ectopic ACTH syndrome

3. Ectopic release of CRH

What typically causes Cushing's disease?

ACTH-secreting corticotroph adenoma

What is an ectopic ACTH syndrome?

adenoma outside of the pituitary which secretes ACTH

What is a result of over secretion of ACTH?

overproduction of the adrenal androgens

What causes ACTH-independent Cushing's syndrome?

the adrenal gland itself

What are some of the causes of ACTH-independent?

1. *unilateral adrenal adenoma or carcinoma in the zona fasciculata

2. primary pigmented nodular adrenocortical disease (PPNAD)

3. McCune-Albright syndrome

4. Iatrogenic

What else can cause Cushing's syndrome?

alcoholism

How does alcohol cause Cushing's syndrome?

stimulates parvocellular neurons of the paraventricular nuclei to release CRH

Causes of Cushing's disease

1. anterior pituitary corticotroph adenoma

2. metastatic disease

T/F: Pituitary adenomas or carcinomas respond to double negative feedback inhibition by cortisol.

F

How does Cushing's disease affect the adrenal gland?

develops bilateral adrenocortical hyperplasia

Ectopic ACTH syndrome

tumors outside the pituitary gland (often in the lungs) that produce ACTH

Most common example of ectopia ACTH syndrome:

small-cell lung carcinoma (50%)

ACTH independent causes what?

adrenal adenoma made of fasciculata cells that secrete cortisol

What is the #1 cause of ACTH-Independent Cushing's Syndrome?

adrenal adenoma