Adrenal Gland

Question 1

C/S: Stress leukogram, hypertension, muscle wasting, weakness….what dz is coming to mind?

Answer 1

Cushings

Question 2

C/S: Hypotension and cardiac failure, weakness, vomiting, anorexia–what dz are you thinking?

Answer 2

Addisons

Question 3

What spp and age is hypercortisolism common in?

Answer 3

Old Dogs

Question 4

What is the most common type of cushings?

Answer 4

Secondary Hyperadrenocortism-PDH

Question 5

You find a lesion in the adrenal cortex that is a single nodule that is well demarcated, unilateral and yellow

What are you thinking?

Answer 5

Cortical Adenoma

Question 6

What are your DDx for a nodule in the cortex of the adrenal gland?

Answer 6

Nodular hyperplasia

adenoma

Question 7

Lesion: bilateral and invading the vena cava or aorta, intraabdominal hemorrhage.

Answer 7

Cortical Carcinoma

Question 8

Why would you have severe atrophy of the cortex in a carcinoma of the cortex?

Answer 8

Negative feedback inhibition of pituitary ACTH secretion by the increase in blood cortisol.

Question 9

Lesion: Multiple, well-defined, yellow, spherical nodules in the cortex or attached to capsule. often bilateral.

Answer 9

Nodular Hyperplasia

Question 10

What spp is nodular hyperplasia common in?

Answer 10

Old horses, dogs, cats and female ferrets

Question 11

You see an animal with greater muscle mass, well developed crest, hypertrophy of clitoris and involution of mammary gland. What are you thinking and what spp is this common in?

Answer 11

Nodular hyerplasia of cortex in the female ferret

Question 12

Lesion: Uniform, usually bilateral, enlargement of the adrenal cortices.

What causes this?

Answer 12

Diffuse cortical hyperplasia

Response to ACTH hyper-secretion from pituitary gland (adenoma)

or idiopathic

Question 13

Lesion: Increase inner 2 zones–> marked hypertrophy and hyperplasia of cells of the zona fasciculata and zona reticularis

Answer 13

Diffuse Cortical hyperplasia

Question 14

Secondary hyperadrenocorticism path?

Answer 14

Increase in ACTH from a PT (PDH) causing bilateral cortical hyperplasia.

Question 15

What are some examples of an Ectopic ACTH syndrome (paraneoplasia)

Answer 15

Small cell lung cancer

Carcinoid tumor

Thymomas

Pancreatic islet cell tumors

Medullary Carcinomas of the thyroid

Question 16

C/S: PU/PD, polyphagia, osteoporosis, DM, obesity.

Answer 16

Hypercortisolism

Question 17

A dog comes in with a hepatomegaly, and a pendulous abdomen and hair losss

Answer 17

Cushings

Question 18

What does the acronym CUSHINGOID stand for?

Answer 18

Cataracts
Ulcers
Skin
Hypertension/hirutism/hyperglycemia
Infection
Necrosis
Glycosuria
Osteoporosis/obesity
Immunosuppresion
Diabetes

Question 19

What is the most common cause for primary hypoadrenocorticism?

Who is this common in?

Answer 19

Bilateral idiopathic adrenal cortical ATROPHY

Young to middle age female dogs

Question 20

What part of the adrenal gland does the bilateral idiopathic adrenal cortical atrophy occur?

Answer 20

ALL 3 CORTICAL

LAYERS

Question 21

What is another cause of primary hypoadrenocorticism and whats it due to?

Answer 21

Bilateral destruction of the adrenal glands due to

Adrenalitis, necrosis/infarction, hemorrhage, tumor

Question 22

Adrenalitis can cause what? and what are some causes of adrenalitis?

Answer 22

Bilateral destruction of the adrenal glands-hypoadrenocorticism

Viruses, bacteria, fungi, parasites

Question 23

Lesion: Multifocal necrosis w/intranuclear inclusion bodies

Answer 23

Herpesvirus: adrenalitis

Question 24

Necrosuppurative adrenalitis can be caused by?

Answer 24

Gram negative Bacterias

Question 25

Granulomatous adrenalitis caused by?

Answer 25

Mycobacteria or fungi (crypto)

Question 26

What can toxoplasma gondii cause in the adrenal gland?

Answer 26

Adrenalitis

Question 27

Necrosis with an infiltration of histiocytes in the adrenal cortex of many spp is caused by?

Answer 27

Toxoplasma gondii

Question 28

The cortex is BIG and red, what does this signal and what could have caused it?

Answer 28

Hemorrhage! Trauma in newborns Severe Stress Septicemia/toxemia

Question 29

What happens when you suddenly withdraw synthetic steroids after prolonged excessive administration? Whats the adrenal gland going to look like? Is this primary or secondary?

Answer 29

Iatrogenic Primary Hypoadrenocorticism Small cortex Primary cause

Question 30

What can cause a secondary hypoadrenocorticism

Answer 30

ACTH deficiency from destructive pituitary lesion

Question 31

What is the hallmark C/S of Addisons Dz

Answer 31

Hypokaluria Hyperkalemia

Question 32

In chronic cases of Addisons what are some c/s?

Answer 32

Hyperpigmentation from a primary adrenal failure. Adrenals put out less cortisol=pit responds by increasing ACTH derived from POMC--inc MSH

Question 33

What is a common dz in ferrets regarding the adrenal gland?

Answer 33

Functional proliferative neoplasms.

Question 34

What ways can the adrenal gland enlarge with functional proliferative lesions?

Answer 34

Bilaterally: diffuse or nodular hyperplasia Unilateral adrenal cortical adenoma or carcinoma

Question 35

You have an animal come in with bilaterally symmetrical alopecia on the ventral abdomen and medial aspects of rear legs, PU/PD and increased plasma conc of estradiol-17B WHat are you thinking and what spp?

Answer 35

Fx prol lesion in a ferret

Question 36

What other c/s can you see in fx prol lesions in ferrets?

Answer 36

Vulvular enlargement Palpable mass at the cranial pole of the kidneys (left>right) Anemia-thrombocytopenia

Question 37

What are some common causes of hyperaldosteronism in cats?

Answer 37

Adrenocortical carcinoma adenoma hyperplasia

Question 38

What have an older cat that comes into the clinic with systemic hypertension, muscle weakness with hypernatremia and marked hypokalemia...what ya thinking?

Answer 38

HyPERaldosteronism

Question 39

What does the adrenal medulla consist of?

Answer 39

Pheochromocytes and a few ganglion cells

Question 40

Conversion of norepinephrine to epinephrine is ____ dependent?

Answer 40

Cortisol

Question 41

Is the adrenal medulla essential for life?

Answer 41

NO

Question 42

What is the most common neoplasm of the adrenal medulla?

Answer 42

Pheochromocytoma

Question 43

Where can extraadrenal pheochromacytomas occur at?

Answer 43

Abdomen

Question 44

Lesion of a pheochromocytoma? Is this a functional neoplasm?

Answer 44

Large, light brown to yellow-red. Unilateral or bilateral encapsulated but can invade the vena cava and metastasize extensively. Rare functional

Question 45

Ateriolar sclerosis and widespread medial hyperplasia of arterioles have been reported in dogs with what? Which a paroxysmal hypertension?

Answer 45

Pheochromocytoma

Question 46

What stain do you use to Dx Pheochromocytomas?

Answer 46

Potassium dichromate or iodate to a freshly cut surface should turn dark brown in 5-20 mins