Adrenal Gland Flashcards
C/S: Stress leukogram, hypertension, muscle wasting, weakness….what dz is coming to mind?
Cushings
C/S: Hypotension and cardiac failure, weakness, vomiting, anorexia–what dz are you thinking?
Addisons
What spp and age is hypercortisolism common in?
Old Dogs
What is the most common type of cushings?
Secondary Hyperadrenocortism-PDH
You find a lesion in the adrenal cortex that is a single nodule that is well demarcated, unilateral and yellow
What are you thinking?
Cortical Adenoma
What are your DDx for a nodule in the cortex of the adrenal gland?
Nodular hyperplasia
adenoma
Lesion: bilateral and invading the vena cava or aorta, intraabdominal hemorrhage.
Cortical Carcinoma
Why would you have severe atrophy of the cortex in a carcinoma of the cortex?
Negative feedback inhibition of pituitary ACTH secretion by the increase in blood cortisol.
Lesion: Multiple, well-defined, yellow, spherical nodules in the cortex or attached to capsule. often bilateral.
Nodular Hyperplasia
What spp is nodular hyperplasia common in?
Old horses, dogs, cats and female ferrets
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?
Nodular hyerplasia of cortex in the female ferret
Lesion: Uniform, usually bilateral, enlargement of the adrenal cortices.
What causes this?
Diffuse cortical hyperplasia
Response to ACTH hyper-secretion from pituitary gland (adenoma)
or idiopathic
Lesion: Increase inner 2 zones–> marked hypertrophy and hyperplasia of cells of the zona fasciculata and zona reticularis
Diffuse Cortical hyperplasia
Secondary hyperadrenocorticism path?
Increase in ACTH from a PT (PDH) causing bilateral cortical hyperplasia.
What are some examples of an Ectopic ACTH syndrome (paraneoplasia)
Small cell lung cancer
Carcinoid tumor
Thymomas
Pancreatic islet cell tumors
Medullary Carcinomas of the thyroid
C/S: PU/PD, polyphagia, osteoporosis, DM, obesity.
Hypercortisolism
A dog comes in with a hepatomegaly, and a pendulous abdomen and hair losss
Cushings
What does the acronym CUSHINGOID stand for?
Cataracts Ulcers Skin Hypertension/hirutism/hyperglycemia Infection Necrosis Glycosuria Osteoporosis/obesity Immunosuppresion Diabetes
What is the most common cause for primary hypoadrenocorticism?
Who is this common in?
Bilateral idiopathic adrenal cortical ATROPHY
Young to middle age female dogs
What part of the adrenal gland does the bilateral idiopathic adrenal cortical atrophy occur?
ALL 3 CORTICAL
LAYERS
What is another cause of primary hypoadrenocorticism and whats it due to?
Bilateral destruction of the adrenal glands due to
Adrenalitis, necrosis/infarction, hemorrhage, tumor
Adrenalitis can cause what? and what are some causes of adrenalitis?
Bilateral destruction of the adrenal glands-hypoadrenocorticism
Viruses, bacteria, fungi, parasites
Lesion: Multifocal necrosis w/intranuclear inclusion bodies
Herpesvirus: adrenalitis
Necrosuppurative adrenalitis can be caused by?
Gram negative Bacterias
Granulomatous adrenalitis caused by?
Mycobacteria or fungi (crypto)
What can toxoplasma gondii cause in the adrenal gland?
Adrenalitis
Necrosis with an infiltration of histiocytes in the adrenal cortex of many spp is caused by?
Toxoplasma gondii
The cortex is BIG and red, what does this signal and what could have caused it?
Hemorrhage!
Trauma in newborns
Severe Stress
Septicemia/toxemia
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?
Iatrogenic Primary Hypoadrenocorticism
Small cortex
Primary cause
What can cause a secondary hypoadrenocorticism
ACTH deficiency from destructive pituitary lesion
What is the hallmark C/S of Addisons Dz
Hypokaluria Hyperkalemia
In chronic cases of Addisons what are some c/s?
Hyperpigmentation from a primary adrenal failure. Adrenals put out less cortisol=pit responds by increasing ACTH derived from POMC–inc MSH
What is a common dz in ferrets regarding the adrenal gland?
Functional proliferative neoplasms.
What ways can the adrenal gland enlarge with functional proliferative lesions?
Bilaterally: diffuse or nodular hyperplasia
Unilateral adrenal cortical adenoma or carcinoma
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?
Fx prol lesion in a ferret
What other c/s can you see in fx prol lesions in ferrets?
Vulvular enlargement
Palpable mass at the cranial pole of the kidneys (left>right)
Anemia-thrombocytopenia
What are some common causes of hyperaldosteronism in cats?
Adrenocortical carcinoma
adenoma
hyperplasia
What have an older cat that comes into the clinic with systemic hypertension, muscle weakness with hypernatremia and marked hypokalemia…what ya thinking?
HyPERaldosteronism
What does the adrenal medulla consist of?
Pheochromocytes and a few ganglion cells
Conversion of norepinephrine to epinephrine is ____ dependent?
Cortisol
Is the adrenal medulla essential for life?
NO
What is the most common neoplasm of the adrenal medulla?
Pheochromocytoma
Where can extraadrenal pheochromacytomas occur at?
Abdomen
Lesion of a pheochromocytoma?
Is this a functional neoplasm?
Large, light brown to yellow-red. Unilateral or bilateral
encapsulated but can invade the vena cava and metastasize extensively.
Rare functional
Ateriolar sclerosis and widespread medial hyperplasia of arterioles have been reported in dogs with what? Which a paroxysmal hypertension?
Pheochromocytoma
What stain do you use to Dx Pheochromocytomas?
Potassium dichromate or iodate to a freshly cut surface
should turn dark brown in 5-20 mins
