Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

12- SA- Urinary and endocrine disease > Adrenal disease (Cushings) > Flashcards

Adrenal disease (Cushings) Flashcards

1
Q

List the 4 types of hyperadrenocorticism

A

Pituitary dependent
Adrenal dependent
Iatrogenic
(ectopic ACTH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe signalment of canine hyperadrenocorticism

A

middle aged to old dogs
more females than males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List the clinical signs of cushings

A

PU/PD
polyphagia
Muscle wasting and weakness (pot-belly, panting)
Skin thinning, calcinosis cutis, pigmentation, bruising
Symmetrical hair loss
Reproductive dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List radiographic finding with cushings

A

Good contrast
Hepatomegaly
Pot-bellied appearance
Calcinosis cutis
Distended bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what do you expect to see on haem with cushings

A

Stress leukogram:
- Neutrophilia (mature)
- Lymphopaenia
- Monocytosis
- Absolute eosinopaenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what do you expect to see on biochem with cushings

A

increased ALP
increased ALT activity
hyperglycaemia
elevated phosphorous
increased cholesterol
mildly abnormal bile acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what do you expect to see on urinalysis with cushings

A

Urine specific gravity <1.030 despite often mild dehydration
Mild glucosuria in some cases
Proteinuria in some cases
positive urine culture- due to reduced immune function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List the 4 diagnostic tests for cushings

A

Low-dose dexamethasone
ACTH response
Urinary cortisol:creatinine ratio
Steroid induced alkaline phosphatase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe what happens in pituitary dependent hyperadrenocorticism

A

the pituitary gland doesn’t respond to the negative feedback stimulated by high cortisol levels
adrenal glands hypertrophy and cortisol levels increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe what happens in adrenal dependent hyperadrenocorticism

A

excess cortisol produced by the adrenal glands
negative feedback causes reduced GnRH
contralateral adrenal gland atrophies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when should we do cushings test

A

in a dog that has appropriate clinical signs and some supporting lab results

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when should we not do cushings tests and why

A

in dogs with no supportive clinical signs and lab findings
or
in an ill dog, as we may get false +ves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List 2 tests which we can use to differentiate between pituitary and adrenal hyperadrenocorticism

A

dexamethasone supression
endogenous ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is seen if dexamethasone test performed on normal dog

A

in normal dog= causes suppression of pituitary secretions- cortisol is supressed at 3-8 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what happens in a dog with pituitary cushings in the dexamethasone test

A

There isn’t effective -ve feedback - therefore cortisol only midly reduces at 3 hr mark then back to an increased level at 8 hour mark

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what happens with a dog with adrenal cushings in the dexamethsone test

A

no response in the cortisol level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the ACTH response test

A

give injection of ACTH, this should cause an increase in cortisol

if the cortisol increases too much, then this indicates hyperadrenocorticism is present

occasionally adrenal tumours can cause a flatline or midrange result

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what can cause a low response on the ACTH stim test

A

exogenous steroid administration

19
Q

why is the urinary cortisol:creatinine test not often used

A

it is very prone to stress false positives

20
Q

Which cushings test is the most sensitive

A

low dose dexamethaone test
and the UCCR

21
Q

which cushings test is the most specific (most confidence in positive result)

A

ACTH stim test

22
Q

How do we diagnose HAC if we have DM

A

use non DM clinical signs- hair loss, thin skin, bruising, high insulin requirement

23
Q

If an animal has HAC and DM which do we treat first

A

DM

24
Q

Describe how high dose dexamethasone differentiate adrenal and pituitary HAC

A

in high dose dex, a suppression of over 50% rules out adrenal source

25
Q

what do we see on imaging of the adrenals in PDH

A

symmetrical adrenals with normal conformation

26
Q

what do we see on imaging the adrenals in ADH

A

one enlarged gland and one atrophied gland

27
Q

List the medical treatment options for HAC

A

trilostane is the only licensed medicine

28
Q

List the surgical treatment options for ADH

A

adrenalectomy

29
Q

List the surgical options for pituitary dependent hyperadrenocorticism

A

hypophysectomy

30
Q

Decsribe how trilostane works

A

It competes for an enzyme and stops progesterone production- which must later effect cortisol production???

31
Q

why do we have to be carefulhow low we make the glucocorticoids levels

A

we need some negative feedback in order to prevent adrenal enlargement

32
Q

why is SID dosing useful when treating HAC

A

it reduces overall exposeure to glucocorticoids but avoids aggressive therapy

33
Q

What are the 2 categories of classic functional adrenocortical tumours

A

cortisol secreting
aldosterone secreting

34
Q

How do animals with glucocorticoid like functional adrenocortical tumours present

A

similar to HAC

35
Q

How do you diagnose animals with glucocorticoid like functional adrenocortical tumours

A

ACTH stim test

36
Q

Describe how to treat animals with glucocorticoid like functional adrenocortical tumours

A

surgical or medical (trilostane)- surgical preferred

37
Q

Describe how animals with mineralcorticoid like functional adrenocortical tumours present

A

hypokalaemia
muscle weakness

38
Q

Describe how to diagnose animals with mineralocorticoid like functional adrenocortical tumours

A

ACTH stim test and measure aldosterone production

39
Q

Describe how to treat animals with mieralocorticoid like functional adrenocortical tumours

A

surgical (preferred method) or medical (spironolactone)

40
Q

what is a phaechromocytoma

A

neuroendocrine tumours growing from chromaffin cells in the adrenal medulla

41
Q

List the clinical signs of a phaechromocytoma

A

weakness/collapse
weight loss
poor appetite
tachypnoea
PUPD
tachycardia
hypertension
panting
restlessness
high blood glucose

42
Q

Describe how to treat phaechromocytoma

A

surgery or symptomatic treatment

43
Q

Describe how to diagnose phaechromocytoma

A

histologically or testing for urinary catecholaemine metabolites

12- SA- Urinary and endocrine disease (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions