Lectures 6-8 - Cushing's

Question 1

ACTH is produced where?

Answer 1

anterior pituitary

Question 2

Types of Cushing’s

Answer 2

PDH
ADH
Iatrogenic
Atypical/Occult
Food Dependent

Question 3

c/s of cushing’s

Answer 3

pupd, pendulous abdomen, dehydration, depression, muscle wasting and weakness, truncal alopecia, calcinosis cutis, exophthalmos, etc

Question 4

What are the 4-5 P’s of cushing’s?

Answer 4

Polyphagia
Polydipsia
Pot belly
Polyuria
+/- panting

Question 5

Zona glomerulosa produces?

Answer 5

SALT
MINERALOCORTICOIDS
ALDOSTERONE

Question 6

Zona fasciculata produces?

Answer 6

SUGAR
GLUCOCORTICOIDS
CORTISOL

Question 7

Zona reticularis produces?

Answer 7

SEX
ANDROGENS, SEX HORMONES
atypical cushing’s maybe???

Question 8

Common signalment for ADH dogs?

Answer 8

small and large
mostly female
poodles, GSDs, dachshunds, labs, terriers, spaniels, malamutes

Question 9

Common signalment for PDH?

Answer 9

smaller toy breeds <20kg
poodle, dachshund, beagles, bostons, schnauzers, GSDs

Question 10

Age signalment for cushing’s

Answer 10

older

Question 11

Is pseudomyotonia treatable?

Answer 11

no

Question 12

What are the complications of Cushing’s?

Answer 12

UTI
recurrent infections
calcium oxalate urolithiasis
hepatobiliary disease

Question 13

What is more common: PDH or ADH?

Answer 13

PDH

Question 14

What level is ACTH in PDH?

Answer 14

INCREASED

Question 15

What level is ACTH in ADH?

Answer 15

DECREASED

Question 16

PDH does what with cortisol?

Answer 16

it ignores the adrenal gland’s negative feedback from excess cortisol

Question 17

ADH does what with cortisol?

Answer 17

produces excess cortisol so pituitary stops making ACTH and adrenal keeps making cortisol

Question 18

T/F: ADH is usually unilateral and has a 50/50 chance of being benign or malignant.

Answer 18

true

Question 19

In which type of Cushing’s do you see micro and macroadenomas?

Answer 19

PDH

Question 20

What should be your last phase of a cushing’s work up if your pt is neuro?

Answer 20

CT/MRI

Question 21

What causes iatrogenic cushing’s?

Answer 21

exogenous intake of glucocorticoids

Question 22

Most cats have what type of cushing’s?

Answer 22

PDH

Question 23

Key c/s of cats with cushing’s

Answer 23

diabetes mellitus, alopecia, thin fragile skin, pupd, polyphagia, abdominal distention, muscle wasting

Question 24

What is another DDx for cushing like symptoms in a cat?

Answer 24

lymphoma

Question 25

50% of PDH cats have pituitary (micro/macro)adenomas.

Answer 25

macro

Question 26

If your feline patient has concurrent cushing's and unregulated diabetes mellitus, what happens with their weight?

Answer 26

loss

Question 27

If your feline patient has concurrent unregulated diabetes mellitus with concurrent acromegaly, what happens with their weight?

Answer 27

gain

Question 28

What clin path abnormalities will you see with cushing's?

Answer 28

hyperglycemia, anemia, hypochloremia, hypertriglyceridemia, normal T4

Question 29

Tx of Cushing's in cats

Answer 29

surgery radiation trilostane

Question 30

Iatrogenic Cushing's has what levels of ACTH?

Answer 30

low

Question 31

If you have a sick patient, what should you use to diagnose your patient with cushing's?

Answer 31

ACTH stim