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Quizzes > Health & Medicine > Human Anatomy & Medicine

How Well Do You Know Your Adrenal Glands?

Ready to master adrenal gland function and endocrine system trivia? Take the quiz now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art adrenal glands and endocrine organs on dark blue background with quiz about hormone function anatomy trivia

Whether you're a student aiming for med school, a health pro sharpening your expertise, or simply fascinated by body science, it's time to put your knowledge to the test with our adrenal gland quiz! This free adrenal gland function quiz guides you through adrenal anatomy, the punchy roles of cortisol and adrenaline, and the tiny marvels that keep our metabolism in check. Challenge yourself with hormone gland questions that cover stress responses and energy balance while brushing up on essential endocrine system trivia. Ready to broaden your horizon? Dive into our endocrine system quiz and then tackle the endocrine hormone quiz . Launch the adrenal anatomy quiz now - show off your glandular genius today!

Which layer of the adrenal cortex produces mineralocorticoids such as aldosterone?
Zona fasciculata
Adrenal medulla
Zona glomerulosa
Zona reticularis
The zona glomerulosa is the outermost layer of the adrenal cortex and is responsible for mineralocorticoid synthesis, primarily aldosterone, which regulates sodium and potassium balance. Aldosterone acts on the distal tubules of the kidney to increase sodium reabsorption and potassium excretion. NCBI - Adrenal Cortex Physiology
Which hormone is secreted by the adrenal medulla?
Aldosterone
Testosterone
Cortisol
Epinephrine
The adrenal medulla secretes catecholamines, primarily epinephrine (adrenaline) and norepinephrine, in response to sympathetic nervous system activation. Epinephrine increases heart rate, dilates airways, and mobilizes energy stores during stress. Endocrine Society - Adrenal Medulla Regulation
What is the primary function of cortisol?
Increase gluconeogenesis
Increase protein synthesis
Regulate circadian rhythm
Reduce blood glucose
Cortisol, a glucocorticoid produced by the zona fasciculata, promotes gluconeogenesis in the liver, raising blood glucose levels especially during stress. It also has anti-inflammatory and immunosuppressive effects. NCBI - Glucocorticoid Action
Which axis regulates cortisol secretion?
Renin - angiotensin - aldosterone system
Hypothalamic - pituitary - adrenal axis
Sympathetic - adrenal - medullary axis
Hypothalamic - pituitary - gonadal axis
Cortisol secretion is regulated by the HPA axis: CRH from the hypothalamus stimulates ACTH from the pituitary, which in turn triggers cortisol release from the adrenal cortex. Negative feedback by cortisol suppresses CRH and ACTH. NCBI - HPA Axis
Which electrolyte imbalance is characteristic of primary hyperaldosteronism?
Hyponatremia and hyperkalemia
Hypernatremia and hyperkalemia
Hyponatremia and hypokalemia
Hypernatremia and hypokalemia
Primary hyperaldosteronism (Conn's syndrome) leads to excess aldosterone, causing increased sodium reabsorption (hypernatremia) and potassium excretion (hypokalemia). Patients often present with hypertension and muscle weakness. UpToDate - Primary Hyperaldosteronism
Which of these is a key stimulus for aldosterone secretion?
Low plasma cortisol
High plasma glucose
Low plasma sodium
High plasma potassium
Elevated plasma potassium directly stimulates the zona glomerulosa to secrete aldosterone, helping restore normal potassium levels. Angiotensin II also promotes aldosterone release. NCBI - Aldosterone Regulation
What is the primary precursor molecule for adrenal steroid synthesis?
Glucose
Amino acids
Cholesterol
Fatty acids
Cholesterol is the precursor for all adrenal steroids (glucocorticoids, mineralocorticoids, and androgens). It is transported into mitochondria by StAR protein for conversion to pregnenolone. NCBI - Steroidogenesis
Which of the following is NOT produced by the adrenal cortex?
Epinephrine
Aldosterone
Cortisol
Dehydroepiandrosterone (DHEA)
Epinephrine is synthesized in the adrenal medulla, not the cortex. The cortex produces glucocorticoids (cortisol), mineralocorticoids (aldosterone), and androgens (DHEA). EndocrineWeb - Adrenal Cortex vs Medulla
Which hormone has anti-inflammatory effects and is used therapeutically?
Norepinephrine
Epinephrine
Aldosterone
Cortisol
Cortisol suppresses immune responses and inflammation by inhibiting cytokine production and T-cell activation. Synthetic analogs, like prednisone, are widely used to treat inflammatory and autoimmune diseases. NCBI - Glucocorticoid Therapy
Which protein transports cholesterol into mitochondria in adrenal cells?
HMG-CoA reductase
LDL receptor
STAR
Albumin
Steroidogenic acute regulatory protein (StAR) facilitates cholesterol transport into mitochondria, the rate-limiting step for steroid hormone synthesis in the adrenal cortex. Mutations in StAR cause congenital lipoid adrenal hyperplasia. NCBI - StAR Function
True or False: The adrenal medulla is derived from neural crest cells.
True
False
During embryonic development, chromaffin cells of the adrenal medulla originate from neural crest cells, similar to peripheral sympathetic neurons. This origin underlies their role in the sympathetic stress response. ScienceDirect - Adrenal Medulla Development
Which enzyme converts cholesterol to pregnenolone?
Aromatase
17?-Hydroxylase
21-Hydroxylase
Side-chain cleavage enzyme
The mitochondrial CYP11A1 enzyme, also known as the side?chain cleavage enzyme, catalyzes the conversion of cholesterol to pregnenolone, the first step in steroidogenesis. NCBI - CYP11A1
Which of these hormones increases during the 'fight or flight' response?
Aldosterone
Cortisol
Epinephrine
Renin
Epinephrine is rapidly released from the adrenal medulla in response to sympathetic stimulation during 'fight or flight,' increasing heart rate, blood pressure, and glucose availability. NCBI - Fight or Flight Response
Which receptor type mediates aldosterone's action in the kidney?
?-adrenergic receptor
Dopamine receptor
Mineralocorticoid receptor
Glucocorticoid receptor
Aldosterone binds to intracellular mineralocorticoid receptors in distal nephron cells, upregulating sodium channels and pumps to increase sodium reabsorption. NCBI - Mineralocorticoid Receptor
Which test is used to diagnose Cushing's syndrome?
Water deprivation test
ACTH stimulation test
Oral glucose tolerance test
Dexamethasone suppression test
The low-dose dexamethasone suppression test assesses whether dexamethasone suppresses cortisol; failure to suppress indicates Cushing's syndrome. Endocrine Society - Cushing's Guidelines
Which hormone's overproduction causes Addison's disease?
Aldosterone
None - Addison's is due to hormone deficiency
Epinephrine
Cortisol
Addison's disease is characterized by primary adrenal insufficiency, leading to deficient cortisol and aldosterone production rather than overproduction. NCBI - Addison's Disease
Which enzyme deficiency causes 21?hydroxylase deficiency congenital adrenal hyperplasia?
CYP11B1
CYP17A1
CYP21A2
CYP11A1
CYP21A2 encodes 21-hydroxylase, and its deficiency leads to impaired cortisol and aldosterone synthesis with androgen excess. This is the most common form of congenital adrenal hyperplasia. NCBI - 21-Hydroxylase Deficiency
What is the effect of ACTH on adrenal cells?
? Cholesterol uptake
? Steroidogenesis
? Catecholamine storage
? Mitochondrial activity
ACTH binds to MC2 receptors on zona fasciculata cells, stimulating cAMP production which enhances cholesterol mobilization and steroidogenesis. NCBI - ACTH Action
Which test differentiates primary from secondary adrenal insufficiency?
High-dose Cosyntropin stimulation
Water deprivation test
Insulin tolerance test
Low-dose Cosyntropin stimulation
A high-dose ACTH (Cosyntropin) stimulation test yields a normal cortisol response in secondary adrenal insufficiency but remains low in primary insufficiency due to adrenal damage. Endocrine Practice - Cosyntropin Testing
Which adrenal disorder presents with hypertension and hypokalemia but low plasma renin?
Addison's disease
Secondary hyperaldosteronism
Cushing's syndrome
Primary hyperaldosteronism
Primary hyperaldosteronism (Conn's syndrome) features autonomous aldosterone secretion causing sodium retention, hypertension, hypokalemia, and suppressed renin. UpToDate - Primary Hyperaldosteronism
Which peptide from the hypothalamus stimulates aldosterone secretion indirectly?
CRH
GHRH
GnRH
Angiotensin II
Angiotensin II, generated via the renin - angiotensin system, directly stimulates the zona glomerulosa to secrete aldosterone, regulating blood pressure and volume. NCBI - Angiotensin II and Aldosterone
Which imaging modality is first-line for suspected adrenal adenoma?
CT scan with washout protocol
Ultrasound
PET scan
MRI with contrast
CT with adrenal washout protocol differentiates adenomas (rapid washout) from malignant lesions. It is sensitive, widely available, and cost-effective. PMC - Adrenal CT Imaging
What is characteristic of an aldosterone-producing adenoma?
Low renin, low aldosterone
High renin, high aldosterone
Low renin, high aldosterone
High renin, low aldosterone
An aldosterone-producing adenoma autonomously secretes aldosterone, suppressing renin via negative feedback. Results are low renin and high aldosterone levels. EndocrineWeb - Primary Aldosteronism
Which transporter is upregulated by aldosterone in the collecting duct?
ENaC
AQP2
Na+/K+ ATPase
NKCC2
Aldosterone increases the expression of the epithelial sodium channel (ENaC) and Na+/K+ ATPase in the principal cells of the collecting duct, enhancing sodium reabsorption. NCBI - Aldosterone and ENaC
Which lab value differentiates primary from secondary Cushing's syndrome?
Plasma potassium
Plasma ACTH
Plasma aldosterone
Plasma renin
In primary Cushing's (adrenal tumor), ACTH is low due to negative feedback, whereas in secondary (pituitary cause) ACTH is elevated or inappropriately normal. Endocrine Society - Cushing's Syndrome
Which cytokine can stimulate cortisol production during inflammation?
IL-4
TNF-?
IL-6
IL-2
Interleukin-6 (IL-6) acts on the adrenal cortex to enhance cortisol secretion during inflammatory states, contributing to the acute phase response. PMC - IL-6 and Cortisol
Which receptor does cortisol bind to in target cells?
GPCR
Nuclear glucocorticoid receptor
Ion channel receptor
Tyrosine kinase receptor
Cortisol enters cells and binds to cytosolic glucocorticoid receptors, which translocate to the nucleus to regulate gene transcription. NCBI - Glucocorticoid Receptor
Which molecular defect underlies familial hyperaldosteronism type I?
Chimeric CYP11B1/CYP11B2 gene
Loss of StAR protein
Mutant AT1 receptor
Gain of MC2 receptor
In familial hyperaldosteronism type I (glucocorticoid-remediable aldosteronism), unequal crossing over creates a chimeric gene combining regulatory sequences of CYP11B1 with coding region of CYP11B2, causing ACTH-driven aldosterone production. NCBI - FH Type I
Which adrenal cell expresses chromogranin A?
Zona reticularis cells
Zona fasciculata cells
Zona glomerulosa cells
Medullary chromaffin cells
Chromogranin A is a secretory protein stored in chromaffin granules of adrenal medullary cells and is a marker for neuroendocrine tumors. PMC - Chromogranin A
Which condition causes bilateral adrenal hyperplasia with virilization?
Pheochromocytoma
Primary hyperaldosteronism
21-hydroxylase deficiency
Cushing's disease
21-hydroxylase deficiency CAH leads to cortisol deficiency and androgen excess, causing bilateral adrenal hyperplasia and virilization in genetic females. NCBI - Congenital Adrenal Hyperplasia
Which enzyme converts norepinephrine to epinephrine?
Dopamine ?-hydroxylase
Monoamine oxidase
Phenylethanolamine N-methyltransferase
Tyrosine hydroxylase
Phenylethanolamine N-methyltransferase (PNMT) catalyzes methylation of norepinephrine to form epinephrine in the adrenal medulla, under control of cortisol from the cortex. NCBI - PNMT
Which mutation is most associated with pheochromocytoma in von Hippel-Lindau disease?
SDHB gene
NF1 tumor suppressor gene
VHL tumor suppressor gene
RET proto-oncogene
Von Hippel-Lindau disease is caused by mutations in the VHL tumor suppressor gene, leading to pheochromocytomas among other tumors due to dysregulated hypoxia-inducible factors. NCBI - VHL Disease
Which steroidogenic enzyme deficiency can lead to hypertension and virilization?
17?-hydroxylase
11?-hydroxylase
21-hydroxylase
3?-hydroxysteroid dehydrogenase
11?-hydroxylase deficiency causes accumulation of 11-deoxycortisol and 11-deoxycorticosterone, leading to hypertension, and shunting of precursors into androgen synthesis causing virilization. NCBI - CAH Variants
Which signaling cascade is activated by angiotensin II in zona glomerulosa cells?
cAMP/PKA
IP3/DAG
JAK/STAT
MAPK/ERK
Angiotensin II binds AT1 receptors, activating Gq proteins and phospholipase C, generating IP3 and DAG, which increase intracellular calcium and activate PKC to stimulate aldosterone synthesis. NCBI - Ang II Signaling
Which laboratory finding distinguishes adrenal carcinoma from benign adenoma?
Rapid contrast washout on CT
Low 24-hr urinary cortisol
Very high DHEA-S levels
Elevated chromogranin A
Adrenocortical carcinomas often produce large amounts of adrenal androgens like DHEA-S, whereas benign adenomas typically do not. Very high DHEA-S suggests malignancy. Endocrine Society - Adrenal Carcinoma
Which genetic defect causes Waterhouse-Friderichsen syndrome?
Autoimmune destruction of adrenal cortex
Mutations in CYP21A2
ACTH receptor mutation
Neisseria meningitidis endotoxin-mediated hemorrhage
Waterhouse-Friderichsen syndrome is due to overwhelming Neisseria meningitidis infection causing adrenal cortical hemorrhage and acute adrenal insufficiency. NCBI - WFS
Which cofactor is required for 21-hydroxylase activity?
FAD
NADPH
Biotin
Thiamine pyrophosphate
21-hydroxylase (CYP21A2) is a cytochrome P450 enzyme that requires NADPH-ferredoxin reductase and NADPH as electron donors for steroid hydroxylation. NCBI - CYP21A2 Cofactors
Which cellular organelle is the site of the first step in steroidogenesis?
Nucleus
Smooth endoplasmic reticulum
Golgi apparatus
Mitochondria
The conversion of cholesterol to pregnenolone by CYP11A1 occurs in the inner mitochondrial membrane, the first step in steroid hormone synthesis. NCBI - Steroidogenesis Organelle
Which feature is characteristic of subclinical Cushing's syndrome?
Hypercortisolism on testing without classic signs
Marked weight loss
Overt muscle wasting
Hypoglycemia
Subclinical Cushing's presents with biochemical evidence of hypercortisolism but lacks the full spectrum of clinical signs like moon facies or muscle wasting. PMC - Subclinical Cushing's
Which pathway is upregulated by cortisol to provide substrates for gluconeogenesis?
Fatty acid synthesis
Pentose phosphate pathway
Glycolysis
Glycogenolysis
Cortisol stimulates glycogenolysis and proteolysis to generate glucose and amino acid substrates for gluconeogenesis in the liver. NCBI - Cortisol Metabolism
Which transporter brings cholesterol into the mitochondria for steroid synthesis?
SR-BI
ABCA1
NPC1
StAR
Steroidogenic acute regulatory protein (StAR) is critical for cholesterol transfer from the outer to inner mitochondrial membrane for conversion to pregnenolone. NCBI - StAR Function
Which pathology shows nodular hyperplasia of the adrenal cortex with excess aldosterone?
Waterhouse-Friderichsen syndrome
Cushing's disease
Conn's syndrome
Addison's disease
Conn's syndrome refers to primary hyperaldosteronism due to adrenal adenoma or bilateral nodular hyperplasia leading to excess aldosterone production. NCBI - Primary Hyperaldosteronism
Which autoimmune condition commonly coexists with Addison's disease?
Hashimoto's thyroiditis
Graves' disease
Multiple sclerosis
Type I diabetes mellitus
Autoimmune adrenalitis (Addison's) often occurs alongside other endocrine autoimmune disorders, most commonly Hashimoto's thyroiditis, as part of polyglandular autoimmune syndrome type II. NCBI - APS II
Which adrenal tumor secretes cortisol independent of ACTH?
Neuroblastoma
Pheochromocytoma
Medullary carcinoma
Adrenal cortical adenoma
Adrenal cortical adenomas may autonomously secrete cortisol, causing ACTH?independent Cushing's syndrome. ACTH levels are suppressed by negative feedback. Endocrine Society - Adrenal Adenomas
Which laboratory ratio is used to screen for primary hyperaldosteronism?
Potassium/aldosterone ratio
ACTH/cortisol ratio
Cortisol/ACTH ratio
Aldosterone/renin ratio
The plasma aldosterone-to-renin ratio is elevated in primary hyperaldosteronism, as aldosterone is high while renin is suppressed. It's the preferred screening test. NCBI - PA Screening
Which microRNA is implicated in regulating CYP11B2 expression in adrenal cells?
miR-16
miR-155
miR-193a-3p
miR-24
Recent studies have shown miR-193a-3p targets CYP11B2 mRNA, modulating aldosterone synthase expression in adrenal glomerulosa cells and influencing aldosterone production. PMC - miR-193a-3p in Adrenal
Which molecular marker differentiates oncocytic adrenal cortical tumors?
MC2 receptor overexpression
MC5 receptor mutation
High mitochondrial density
Chromogranin A positivity
Oncocytic adrenal cortical tumors are characterized by abundant mitochondria in tumor cells, detected on histology or immunohistochemistry, distinguishing them from typical cortical neoplasms. PMC - Oncocytic Adrenocortical Tumors
Which novel therapy targets aberrant Wnt/?-catenin signaling in adrenal carcinoma?
Ketoconazole
Mitotane
Spironolactone
PRI-724
PRI-724 is an experimental inhibitor of the Wnt/?-catenin pathway under investigation for adrenocortical carcinoma, which often harbors activating mutations in CTNNB1. ClinicalTrials.gov - PRI-724
Which epigenetic modification is linked to decreased DHEA-S production in aging adrenal glands?
Histone acetylation
Global DNA hydroxymethylation
Promoter hypermethylation of CYP17A1
miR-21 overexpression
Age-related promoter hypermethylation of the CYP17A1 gene reduces transcription of 17?-hydroxylase, leading to decreased DHEA-S synthesis in the aging adrenal reticularis. PMC - Epigenetics in Adrenal Aging
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Study Outcomes

  1. Analyze Adrenal Anatomy -

    Break down the structural regions of the adrenal glands, distinguishing the cortex from the medulla and identifying key tissue layers.

  2. Identify Primary Hormones -

    Recall the main hormones produced by the adrenal cortex and medulla, including cortisol, aldosterone, and adrenaline, and pinpoint their source zones.

  3. Explain Hormone Functions -

    Describe how adrenal hormones regulate stress response, metabolism, and electrolyte balance within the endocrine system.

  4. Differentiate Stress Response Phases -

    Outline the mechanisms of acute versus chronic adrenal activation and how the body adapts to varying stress levels.

  5. Apply Endocrine System Knowledge -

    Connect adrenal gland output to overall endocrine system feedback loops and hormonal interactions.

  6. Evaluate Endocrine Trivia -

    Test and reinforce your mastery of adrenal gland function through challenging endocrine system trivia questions.

Cheat Sheet

  1. Adrenal Cortex Zones & Hormones -

    The adrenal cortex is divided into three layers that produce distinct steroid hormones: the zona glomerulosa (aldosterone), zona fasciculata (cortisol), and zona reticularis (androgens). Use the mnemonic "Salt, Sugar, Sex" (GFR) to remember the order from outermost to innermost (Endocrine Society). Mastering this for your adrenal gland quiz will boost your confidence on hormone gland questions.

  2. Hypothalamic - Pituitary - Adrenal Axis -

    The HPA axis coordinates stress response via CRH from the hypothalamus stimulating ACTH release, which in turn drives cortisol secretion by the adrenal cortex. Cortisol exerts negative feedback on both CRH and ACTH to maintain homeostasis. This feedback loop frequently appears in endocrine system trivia and adrenal gland function quizzes (NIH).

  3. Cortisol's Metabolic & Immune Roles -

    Cortisol exerts pleiotropic effects including gluconeogenesis, immune modulation, and protein catabolism. For example, cortisol upregulates phosphoenolpyruvate carboxykinase (PEPCK) in the liver to boost glucose output (Campbell's Biochemistry). Higher cortisol levels also inhibit leukocyte proliferation to regulate inflammation.

  4. Catecholamine Synthesis in the Medulla -

    The adrenal medulla converts tyrosine into catecholamines via the pathway Tyrosine → DOPA → Dopamine → Norepinephrine → Epinephrine, with key enzymes like tyrosine hydroxylase and PNMT. Remember "Two Dogs Do Need Eggs" for the order (NIH). These hormone gland questions often test your recall of each enzymatic step.

  5. Anatomy & Vascular Supply -

    The adrenal glands sit atop the kidneys and receive blood from three suprarenal arteries. Use the mnemonic "SIP" for Superior (inferior phrenic), Intermediate/middle (aorta), and Inferior (renal artery) supplies (Gray's Anatomy). Understanding venous drainage through a single adrenal vein aids in adrenal imaging and surgery questions.

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