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Module 12 > Endocrine Pathology Examples > Flashcards

Endocrine Pathology Examples Flashcards

(48 cards)

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1
Q

if adrenal cortex is hyperfunctional what hormones are likely to be affected?

A

aldosterone

cortisol

adrenaline

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2
Q

what would occur to the pituitary with elavated cortisol?

A

ACTH would decrese

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3
Q

what would occur to the contralateral adrenal with increased cortisol

A

atrophy

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4
Q

what effects does overproduction of cortisol lead to

A

gluconeogenic

lipolytic

protein catabolic

anti-inflammatroy

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5
Q

what is the difference between pituitary dependent (PDH) and adrenal dependent (ADH) canine cushing’s

A

pituitary: increased ACTH from pituitary –> bilateral stimulation of adrenals –> increased cortisol from both adrenals ~85% of cases

adrenal dependent: adrenal tumour –> increased cortisol from diseased gland –> negative feedback –> less ACTH from pituitary ~15% of cases

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6
Q

what is the third cause of Cushing’s

A

iatrogenic

exogenous source of steroids act in lieu of adrenal cortex (prednisone)

alopecia, fragile skin syndrome

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7
Q

what is adrenal medulla hypofunction

A

rare

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8
Q

what is hyperfunction of adrenal medulla

A

associated with functional neoplasia –> pheochromocytoma

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9
Q

what hormones are effected if adrenal medulla is hyperfunctional

A

adrenaline, noradrenaline, catecholamines

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10
Q

what is pheochromocytoma

A

most common adrenal medullary tumour

usually non-functional

but if functional –> catecholamine release –> tachycardia, edema, cardiac hypertrophy

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11
Q

what are possible primary causes of hypothyroidism

A

idiopathic follicular atrophy

lymphocytic thyroiditis (immune-mediated)

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12
Q

what are secondary causes of hypothyroidism

A

decreased TSH from pituitary disease

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13
Q

what are the effects of hypothyroidism (3)

A

decreased basal metabolic rate

decreased T3, T4

increased cholesterol

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14
Q

what are the metabolic findings of hypothyroidism in dogs

A
  1. lethargy
  2. weight gain
  3. exercise intolerance
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15
Q

what are the dermatological findings of hypothyroidism in dogs (4)

A
  1. hair thinning
  2. poor quality coat
  3. hyperpigmentation
  4. pyoderma
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16
Q

what is the primary pathology of hypothyroidism in dogs

A

small, often pale thyroid

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17
Q

what is the secondary pathology of hypothyroidism (4)

A
  1. hyperkeratosis
  2. hyperpigmentation
  3. myxedema
  4. atherosclerosis
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18
Q

what does atherosclerosis in hypothyroid dog lead to

A

hyperlipidemia –> endothelial damage –> monocyte adhesion + infiltration, smooth muscle migration and proliferation –> lipid accumulation, extracellularly and intracellularly in macrophages and muscle cells

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19
Q

what is a goitre caused by

A
  1. iodine deficiency
  2. iodine toxicity
  3. goitrogenic plants
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20
Q

what does a goitre result in

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A

inadequate T3/T4 synthesis

bilateral enlargement

21
Q

why does inadequate synthesis of T3/T4 lead to bilateral enlargement of the thyroid glands

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A

inadequate thyroxine synthesis –> decreased T3/T4 recognized by the hypothalamus and anterior pituitary –> increased TSH release

22
Q

what are the 3 mechanisms for development of goitre

Study These Flashcards
A
  1. dietary iodine deficiency
  2. block of iodine uptake
  3. enzyme defect
23
Q

what is a goitrogen

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A

compound which result in hyperplastic goitre

24
Q

what are examples of goitrogens

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A

plants: brassica (rape, kale) –> digestion leads to thiocyanate which competes with iodide ions for absorption by thyroid follicular cells
drugs: phenobarbitone, rifampin, increase breakdown of T4 and T3

excessive iodine in diet: foals of mares fed dry seaweed

25
how does enzyme defect cause hypothyroidism
dyshormogenesis due to enzyme defect --\> impaired thyroglobulin biosynthesis massive enlargement of thyroid circulatory level of T3 and T4
26
what is hyperthyroidism
unilateral or bilateral common in cats
27
what are the causes of hyperthyroidism
1. hyperplastic nodules 2. adenoma 3. adenocarcinoma (less common)
28
what is primary hyperthyroidism
multi-nodular hyperplasia --\> thyroid neoplasia --\> feline hyperthyroidism --\> increased T3/T4 levels --\> increased metabolic rate --\> cardiac hypertrophy --\> sudden death
29
what is secondary hyperthyroidism
pituitary dysfunction (very rare) --\> feline hyperthyroidism --\> increased T3/T4 levels --\> increased metabolic rate --\> cardiac hypertrophy --\> sudden death
30
what causes parathyroid hypofunction
rare unless surgically removed --\> causes hypocalcemia
31
what are the causes of hypocalcemia (4)
1. decreased PTH concentration (primary hypoparathyroidism, pseudohypoparathyroidism) --\> decreased PTH receptor responsiveness 2. inadequate Ca mobilization from bone or absorption in intestine (hypovitaminosis D, chronic renal failure, milk fever) 3. excess urinary excretion of Ca: ethylene glycol toxicosis 4. unknown: acute pancreatitis in dogs, urinary tract obstruction
32
what is rickets
dietary Ca/P/Vit D imbalance --\> relative hypocalcemia --\> bone resorption and abnormalities of the growth plate
33
how does excess urinary retention lead to hypocalcemia and what is a common cause of this
ex. antifreeze calcium oxalate crystals form --\> crystals damage kidney --\> renal tubular necrosis --\> hypocalcemia
34
what are the 3 causes of secondary hyperparathyroidism
1. renal (response to chronic hypocalcemia) 2. nutritional (high dietary P, low dietary Ca) 3. pseudohyperparathyroidism (tumours)
35
how does renal secondary hyerparathyroidism occur
1. chronic renal disease - decreased golmerular filtration rate - phosphate retention - continued stimulation of the parathyroid gland - continued resorption of bone --\> fibrous osteodystrophy (bone replaced by fibroblastic tissue, bone remodelling, periosteal new bone formation)
36
how does the normal animal respond to relative hypocalcemia
resorption from bone --\> phosphate excretion in kidney --\> calcium resorption in kidney
37
describe the pathway of secondary renal hyperparathyroidism and chronic renal failure
38
how does nutritional secondary hyperparathyroidism occur
dietary imbalance of calcium and phosphorus (diets with low Ca or high oxalates, diets with high P and low or normal Ca, occasionally vitamin D deficiency) leads to increased PTH production
39
how does pseudohyperparathyroidism occur
humeral hypercalcemia of malignancy (HHM) --\> tumours of non-endocrine origin (lymphoma, multiple myeloma, adenocarcinoma of glands of anal sac) --\> PTHrP (parathyroid hormone related peptide) --\> affected animals have trophic atrophy of the parathyroid glands
40
how does humeral hypercalcemia of malignancy lead to
tumour in parathyroid produces parathyroid hormone related peptide --\> increased intestinal absorption, resorption from bone and decreased renal excretion of Ca --\> hypercalcemia
41
how does functional parathyroid neoplasm lead to hypercalcemia
increased PTH --\> increased intestinal absorption and resorption of Ca from bone as well as decreased renal excretion of Ca --\> hypercalcemia
42
what type of hyperparathyroidism is function parathyroid neoplasm cause
primary
43
what is the clinical syndrome of pancreatic islet hypofunction
diabetes mellitus
44
what is pancreatic islet hypofunction caused by (4)
1. vacuolar degeneration 2. amyloidosis (cats) 3. immune-mediated destruction (dogs) 4. secondary to pancreatitis
45
what does diabetes mellitus occur
46
when does diabetes mellitus occur in cats and dogs
common in cats and dogs in dogs --\> spontaneous diabetes (1:200), middle-aged, females 2x \> males, some small dog breeds increased incidence (min. poodles, dachshunds, terriers)
47
what are islet cell tumours
often B-cell type (insulin secreting) can still have non-functional neoplasms and hyperplasia of the pancreas
48
what is an insulinoma
B-cell (insulin secreting) pancreatic islet hyperfunction increased insulin --\> hypoglycemia --\> decreased glucose bioavailabilty --\> neurologic signs (weakness, lethargy, collapse, seizures, nervousness) --\> adrenal medulla secretes catecholamines --\> increased blood pressure

Module 12 (8 decks)

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