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Clinical Pathology > Adrenal Gland > Flashcards

Adrenal Gland Flashcards

(60 cards)

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1
Q

Which layer of the adrenal cortex releases mineralocorticoids?

A

Zona glomerulosa

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2
Q

Which layer of the adrenal cortex releases androgens?

A

Zona reticularis

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3
Q

Which layer of the adrenal gland releases glucocorticoids?

A

Zona fasciculata

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4
Q

Which functions are listed concerning glucocorticoids?

A
  1. Catabolism (attenuation of healing)
  2. Mobilization of energy sources (gluconeogenesis, lipolysis, & insulin antagonism)
  3. Immunosuppression
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5
Q

What is the function of aldosterone (a mineralocorticoid)?

A

Resolution of hypovolemia (either due to dehydration or blood loss)

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6
Q

What effect does aldosterone have on sodium?

A

Increases sodium retention in the kidney

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7
Q

What effect does aldosterone have on potassium?

A

Increases potassium excretion from the kidney

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8
Q

What is the overall net effect of aldosterone of sodium, potassium, and water levels?

A

Increases sodium

Decreases potassium

Water retention

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9
Q

What are the 3 stimulants for aldosterone release?

A
  1. RAAS
  2. Increased potassium
  3. ACTH
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10
Q

Pituitary-dependent hyperadrenocorticism involves a pituitary tumor that is autonomously secreting what?

A

ACTH

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11
Q

Adrenal-dependent hyperadrenocorticism involves an adrenal tumor that is autonomously secreting what?

A

Cortisol

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12
Q

Pituitary pars intermedia dysfunction involves a pituitary tumor that is autonomously secreting what?

A

POMC

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13
Q

What are the 2 types of pituitary tumors?

A
  1. Microadenoma

2. Macroadenoma

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14
Q

What are the 2 types of adrenal tumors?

A
  1. Adrenoma

2. Adrenocarcinoma

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15
Q

Which is more common, pituitary-dependent or adrenal-dependent?

A

Pituitary-dependent HAC (85% of HAC cases)

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16
Q

What is the typical signalment of a dog with PD-HAC?

A

Small breed dog

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17
Q

What is the typical signalment of a dog with AD-HAC?

A

Large breed dog

German shepherd

Mean age 10 years old

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18
Q

What are the clinical signs associated with hyperadrenocorticism in the dog?

A
  1. PU/PD
  2. Muscle wasting
  3. Pot belly
  4. Alopecia
  5. Polyphagic
  6. Panting
  7. Organomegaly
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19
Q

What are the CBC findings for a dog with hyperadrenocorticism?

A
  1. Anemia
  2. Stress leukogram
  3. Thrombocytosis
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20
Q

What are the chemistry findings for a dog with hyperadrenocorticism?

A
  1. Increased ALP
  2. Increased ALT
  3. Increased bilirubin
  4. Increased lipids
  5. Increased glucose
  6. Decreased tT4
  7. Isosthenuria
  8. Proteinuria
  9. Bacterial cystitis
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21
Q

The cortisol assay cross reacts with all artificial glucocorticoids except what?

A

Dexamethasone

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22
Q

Hyperadrenocorticism dogs should have a _____ cortisol level.

A

Increased

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23
Q

Increased cortisol levels may occur with which 4 pathologic states?

A
  1. PD-HAC
  2. AD-HAC
  3. Stress
  4. Iatrogenic HAC
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24
Q

Baseline [Cortisol] has (good or bad) sensitivity and (good or bad) selectivity.

A

Baseline [Cortisol] has POOR sensitivity AND selectivity = POOR diagnostic utility for HAC!!!

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25
What would baseline [Cortisol] levels be in a normal patient?
WRI
26
What would baseline [Cortisol] levels be in a stressed patient?
WRI or increased
27
What would baseline [Cortisol] levels be in an HAC patient?
WRI or increased
28
What is the test you run first if suspicious of an HAC dog?
UCCR (urine cortisol:creatinine ratio)
29
True or False: [Cortisol] in the urine should be equal to [Cortisol] in the plasma.
TRUE
30
How does the body rid itself of cortisol?
Via the renal secretion into the urine.
31
What would the UCCR be in a patient with HAC?
Increased
32
UCCR (urine cortisol:creatinine ratio) has (good or bad) sensitivity and (good or bad) selectivity.
GOOD sensitivity POOR specificity
33
True or False: Normal dogs ALWAYS have normal UCCR levels.
TRUE
34
True or False: Stressed dogs will always have elevated UCCR levels.
FALSE: it's a 50/50 shot.
35
True or False: A cushing's patient's UCCR is ALWAYS above reference threshold.
TRUE
36
What are the 3 things the ACTH stimulation test is useful in initially diagnosing?
1. PD-HAC 2. AD-HAC 3. Iatrogenic HAC
37
Describe the ACTH stimulation test results in a normal dog:
Stimulated, so post-cortisol levels are 2-3 times greater than the pre-cortisol levels.
38
Describe the ACTH stimulation test results in an HAC dog:
Hyperresponse, so post-cortisol levels are > 22 mg/dl
39
Describe the ACTH stimulation test results in a dog with iatrogenic HAC:
Because the adrenal cortex has been suppressed, there is NO stimulation. Pre-cortisol levels = post-cortisol levels.
40
Explain the low dexamethasone suppression test procedure:
1. Measure pre-cortisol 2. Give low dose Dex 3. Measure post-cortisol at 4th and 8th hours
41
What two things is the low dose dex suppression test useful in initially diagnosing?
1. PD-HAC | 2. AD-HAC
42
Explain the results of the low dose dex suppression test in a dog with AD-HAC:
No suppression
43
Explain the results of the low dose dex suppression test in a dogs with PD-HAC:
Either no suppression OR partial suppression
44
Explain the results of the endogenous ACTH test in a dog with AD-HAC:
Low ACTH
45
Explain the results of the endogenous ACTH test in a dog with PD-HAC:
Elevated ACTH or WRI
46
Explain the results of the high dose dex suppression test in a dog with AD-HAC:
No suppression
47
Explain the results of the high dose dex suppression test in a dog with PD-HAC:
Suppression at 4 +/-8 hour post
48
With Pituitary Pars Intermedia Dysfunction in the horse, what does the increased Alpha/beta MSH lead to? (3 things)
1. Increased hair coat 2. Increased lipid deposition 3. Immunosuppression
49
With Pituitary Pars Intermedia Dysfunction in the horse, what does the increased ACTH lead to?
Hyperadrenocorticism
50
With Pituitary Pars Intermedia Dysfunction in the horse, what does the increased lipotropin lead to?
1. Altered lipid metabolism | 2. Altered steroid synthesis
51
What is the typical signalment of a horse with Pituitary Pars Intermedia Dysfunction?
1. Average age of 18 2. More common in mares 3. Ponies, Morgans more predisposed
52
What are the clinical signs associated with Pituitary Pars Intermedia Dysfunction?
1. PU/PD 2. Hirsutism 3. Muscle loss 4. Laminitis 5. Reproductive failure 6. Secondary infections 7. Increased adiposity
53
What are CBC results consistent with PPID?
1. Stress leukogram
54
What are chem results consistent with PPID?
1. Increased glucose 2. Hyperlipidemia 3. +/- liver enzymes increased
55
Explain the dex suppression test results in a horse with PPID:
No suppression
56
Explain the dex suppression test results in a normal horse:
Suppression
57
Explain the dex suppression test results in a normal horse if tested during the fall months:
No suppression
58
In a horse with PPID, ACTH would be increased or decreased?
Increased
59
In a horse with PPID, alpha-MSH would be increased or decreased?
Increased
60
In a normal horse would the ACTH/alpha-MSH levels be increased or decreased during the fall months?
Increased

Clinical Pathology (8 decks)

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