Exam (elaborations)
PCOL 838 FINAL
- Module
- Pathophysiology EXAM 4 UTA
- Institution
- Pathophysiology EXAM 4 UTA
Exam of 35 pages for the course Pathophysiology EXAM 4 UTA at Pathophysiology EXAM 4 UTA (PCOL 838 FINAL)
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PCOL 838 FINALWhere are the adrenal glands located? (10/18) - ANS-Adrenal glands are located at
superior pole of each kidney
What does the adrenal cortex and the adrenal medulla secrete? (10/18) - ANS-The
adrenal cortex secretes DHEA, mineralocorticoids (e.g., aldosteron) and glucocorticoids
(eg, cortisol).
The adrenal medulla secretes catecholamines (eg, epinephrine, norepinephrine,
dopamine).
What are 5 of the major disorders of the adrenal cortex? (10/18) - ANS-1.
Hypercortisolism (Cushing syndrome)
2. Adrenal insufficiency (Addison disease)
3. Hyperaldosteronism (Aldosteronism)
4. Hypoaldosteronism
5. Androgen Excess- very rare (do not worry about)
What are the layers of the adrenal cortex? (10/18) - ANS-capsule (protective layer)
zona glomerulosa (10%)
zona fasciculata (80%)
zona reticularis (10%)
Which hormones are secreted by each layer of the adrenal cortex? What is the
regulatory control of each of these secretions? (10/18) - ANS-zona glomerulosa:
aldosterone (mineralcorticoid), renin-angiotensin regulation
zona fasciculata: cortisol (glucocorticoid), ACTH regulation
zona reticularis: DHEAs (androgen), ACTH regulation
What is the common substrate of the hormones synthesized in the adrenal cortex?
(10/18) - ANS-cholesterol
Enzyme 21 is an important enzyme in the synthesis of aldosterone and cortisol in the
adrenal cortex. What happens when patients have a mutation in this enzyme? (10/18) -
ANS-some patients have a mutation in enzyme 21, so the intermediate, pregnenolone
goes to produce more androgens which leads to androgen overexpression
,Cortisol circulates in a bound state. What does it bind to? (10/18) - ANS-Both cortisol
and corticosterone are secreted in an unbound state but circulate in a bound state to
corticosteroid-binding globulin (CBG) (or transcortin) (~80%) and to albumin (~10%) to a
lesser extent
What do aldosterone and DHEA bind to in circulation? How are they different from
cortisol? (10/18) - ANS-*Aldosterone: bound to albumin (60%) and transcortin (10%).
*Dehydroepiandrosterone: bound to albumin (50%) and transcortin (17%)
cortisol binds mostly to transcortin (80%)
What three roles are proposed for steroid-binding proteins? (10/18) - ANS-• Distribute
and deliver the hormones to target tissues
• Hormone bound to CBG are protected from metabolism and inactivation
• Assist in maintaining a level of hormones in circulation during episodic secretion by the
gland.
Where is the pancreas located? (10/25) - ANS-The pancreas is a large gland behind the
stomach and next to the small intestine.
What are the 2 main functions of the pancreas? Which function is endocrine and which
is exocrine? (10/25) - ANS-1) It releases powerful digestive enzymes into the small
intestine to aid the digestion of food (Exocrine Function).
2) It releases the hormones insulin and glucagon into the bloodstream to help the body
control how it uses food for energy (Endocrine Function).
What are 4 exocrine pancreatic disorders? (10/25) - ANS-Exocrine Pancreatic Disorders
1. Acute Pancreatitis
2. Chronic pancreatitis
3. Pancreatic Insufficiency
4. Pancreatic cancer
What does the suffix -itis mean? What can cause this? (10/25) - ANS--itis =
inflammation
can be caused by cell death
What is the endocrine portion of the pancreas? (10/25) - ANS-the islets of Langerhans
What do acinar cells and ductal cells secrete? (10/25) - ANS-acinar: digestive enzymes
ductal: pancreatic juice containing NaHCO3
,•Presence of acid in duodenum causes release of _____________.
•Presence of Fats in duodenum causes release of _____________. (10/25) -
ANS-•Presence of acid in duodenum causes release of Secretin.
•Presence of Fats in duodenum causes release of Cholecytokinin (CCK).
•Secretin causes release of _________ from _______________.
•CCK causes secretion of _________ from ____________. (10/25) - ANS-•Secretin
causes release of Bicarbonate from ductal cells.
•CCK causes secretion of pancreatic enzymes from acinar cells.
What are the neural and hormonal controls over exocrine pancreatic function? (10/25) -
ANS-NEURONAL
stimulation of parasympathetic pathways innervating the pancreas causes release of
pancreatic enzymes.
HORMONAL
•Presence of acid in duodenum causes release of Secretin.
•Presence of Fats in duodenum causes release of Cholecytokinin (CCK).
•Secretin causes release of Bicarbonate from ductal cells.
•CCK causes secretion of pancreatic enzymes from acinar cells.
What is pancreatic juice composed of? (10/25) - ANS-electrolytes, active pancreatic
enzymes, zymogens
What happens if there is premature trypsin activation? What is found in acinar cells that
may cause this premature activation? (10/25) - ANS-Premature trypsin activation before
arriving in the duodenum can be destructive and may trigger a series of events that lead
to pancreatic self-digestion.
Cathepsin B within acinar cells is a possible pathological activator of trypsinogen in
pancreatitis
What initially happens with pancreatitis and how does it progress? (10/25) - ANS-Initial
inflammation of the gland --> Swelling of the gland and surrounding blood vessels,
bleeding, infection, and damage to the gland --> Trapping of digestive juices to start
"digesting" the pancreas itself.
What happens in acute pancreatitis and chronic pancreatitis? (10/25) - ANS-ACUTE
Inflammatory process with cytokines
, CHRONIC
Progressive inflammatory process in the pancreas that causes fibrosis (scarring of
tissue), calcifications or stones, and dilated pancreatic duct
What is the preclinical phase of neoplasia? Is it detectable? (11/1) - ANS-dysplasia, it is
undetectable
Most cancer growth is undetectable until there is about 1 billion cancer cells. What are 2
examples of cancers that can be detected at the preclinical phase? (11/1) - ANS-For
some cancers preclinical phase may be detectable:
• Colon cancer-polyps
• Skin cancer-dysplasic nevi
What is the main cause of cancer death? (11/1) - ANS-Cancer death are
often caused by obstruction to normal systemic function
What is the difference between a well differentiated cancer cell and a poorly
differentiated one? (11/1) - ANS-well: less aggressive, easier to get rid of
poorly: can't tell where it comes from, harder to get rid of
What are the three germ layers? Which cancers are associated with them? (11/1) -
ANS-Three germ layers = Ectoderm, endoderm, mesoderm
• Ectoderm, endoderm --> carcinoma
• Mesoderm --> sarcoma
What causes a high prevalence of sarcomas and carcinomas? (11/1) - ANS-• During
infancy mesenchymal tissues are actively dividing --> increased
prevalence of sarcomas
• High turnover of epithelial layer --> high prevalence of carcinomas.
What are the different hallmarks of cancer cells? (11/1) - ANS-
All cancers carry somatic mutations. What is the difference between passenger
mutations and driver mutations? (11/1) - ANS-passenger: just happen to be there
driver: drive different hallmarks of cancer
What do driver mutations do? (11/1) - ANS-• Converts proto-oncogenes to oncogenes
• Inactivates tumor suppressor genes.
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