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VMS 2007 > Adrenal Pathology I > Flashcards

Adrenal Pathology I Flashcards

1
Q

What does the zona glomerulosa secrete?

A

Mineralcorticoids (Aldosterone)

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2
Q

What stimulates the secretion of mineralcorticoids from the zona glomerulosa?

A

Angiotensin II and increased extracellular K+ concentration

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3
Q

What is the function of the zona fasciculata?

A

To produce glucocorticoids such as cortisol

not required for survival

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4
Q

What is the effect of cortisol?

A
  • Induces glucose production
  • Supresses inflammation and immune responses
  • Inhibits wound healing
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5
Q

What is the function of the zona reticularis?

A
  • Produces adrenal sex hormones
  • Only has a minor physiological difference
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6
Q

What is the medulla responsible for?

A

responsible for systemic secretion of the catecholamines
‘fight or flight’ response, increased heart rate, and blood pressure (hyperglycaemia)

adrenal medulla is not required for survival

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7
Q

what is adrenal agenesis

A

rare condition where the adrenals fail to develop, can be either bilateral or unilateral

occurs to accesory adrenal tissue

commonly perirenal or within the testicular sheath/ incidental

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8
Q

what is the blood circulation of the adrenal glands

A
  • sinusoidal plexus through the cortex and medulla
  • fragile and susceptible to death
  • causes extertional deaths in racehorses
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9
Q

what is Waterhouse-Friderichsen syndrome

A

group of conditions where the adrenals fail to function effectively- occurs as a result of bleeding into the glands

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10
Q

What is WFS an expression of in septicaemic cows?

A

DIC (Haemorrhagic adrenal necrosis)

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11
Q

What is adrenalitis?

A

Inflammation of one or both of the adrenal glands

either infectious or autoimmune

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12
Q

What two things can cause adrenal toxicity?

A
  • Mitotane- directly cytotoxic to adrenocortical cells
  • Trilostane
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13
Q

In what animals is adrenocortical hyperplasia common in?

due to sustained physiological stress

A

Common in old dogs, cats and horses

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14
Q

What may adrenocortical hyperplasia represnt?

A

Hyperadrenocorticism
* sustained physiological stress
* sometimes idiopathic and incidental

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15
Q

What is an adrenal cortical adenoma?

A
  • benign neoplasm
  • common in older dogs
  • well-defined encapsulated nodule that compresses or distorts the surrounding tissue
  • may be functional or non-functional
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16
Q

What animals are affected by an adrenal cortical carcinoma?

A
  • Older dogs and cattle
  • large, poorly defined, may efface normal tissue
  • vascular invasion and thrombosis
  • may result in haemoabdomen
  • metastatsize widely
  • can be functional or non-functional
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17
Q

What three conditions are examples of hormonal excess?

A
  • Hyperadrenocorticism -> excess cortisol
  • Atypical hyperadrenocorticism
  • Hyperaldosteronism
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18
Q

What condition is an example of hormonal deficiency?

A

Hypoadrenocorticism (addisons disease)

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19
Q

What are the four forms of hyperadrenocorticism?

A
  • Pituitary-dependnent
  • Adrenal-dependent
  • Iatrogenic
  • Ectopic ACTH secretion
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20
Q

What is pituitary-dependent hyperadrenocorticism?

A
  • Pituitary tumour secretes ACTH
  • Unresponsive to cortisol feedback
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21
Q

What is adrenal-dependent hyperadrenocorticism?

A

Adenal neoplasm secretes excess cortisol independent of the ACTH

22
Q

What is iatogenic hyperadrenocorticism?

A

administration of chronic, high-dose corticosteroids

23
Q

What is Ectopic Hyperadrenocorticism?

A

Secretion of ACTH by non-pituitary neoplasms

24
Q

What are the clinical signs of excess cortisol (hyperadrenocorticism)

A
  • Stress
  • Hair loss
  • Weight gain/ Getting fat
  • Blood glucose increase
  • Supressed immune system
25
Q

What does the skin look like in an animal with hyperadrenocorticism?

A
  • Alopecia in the pressure points (keratin plugs)
  • Dermal atrophy- thin fragile skin, poor wound healing
  • Hyperpigmentation (excess ACTH secretion)
26
Q

What is calcinosis cutis?

A

Calcification of degenerate collagen
other organs may also mineralise

27
Q

What does hyperadrenocorticism look like in terms of muscle?

A
  • Abdominal and limb muscle atrophy
  • ‘pot-belly’ appearance
28
Q

What is a steroid hepatopathy?

A
  • Diffusely enlarged pale liver
  • Midzonal glycogen storage within hepatocytes causing a ‘pot-belly’ appearance
29
Q

Why does hyperadrenocorticism cause polyuria and polyphagia?

A
  • Cortisol causes a decreased sensitivity to ADH
  • Polyphagia may be exaccerbated by diabetes mellitus (direct effect of cortisol only seen in dogs)
30
Q

What does hyperadrenocorticism look like in cats?

A
  • rare and mostly pituitary dependent
  • thin fragile skin
  • curled pinna
31
Q

What does hyperadrenocorticism look like in ferrets?

A
  • excess production of sex hormones such as oestrogens and androgens
  • usually occurs around middle age (3/4)
  • adrenal disease may be related to neutering
32
Q

What are the clinical signs of hyperadrenocorticism in ferrets?

A
  • Hair loss that begins in the tail and then progresses towards the front until the ferret is completely bald
  • Symmetrical
  • All the clinical signs are related to the duration and severity of sex steroid excess
33
Q

What swollen organ is common in ferrets with hyperadrenocorticism?

A
  • Swollen vulva in spayed females
  • Straining to urinate due to an enlarged prostate
  • thinning of skin, muscle wasting, and pot-belly appearance in long term disease
34
Q

What three types of hypoadrenocorticism are there?

A
  • Primary
  • Secondary
  • Iatrogenic
35
Q

What does primary hypoadrenocorticism look like?

A

Most commonly an immune related destruction
related to adrenal destruction due to inflammation, neoplasia, haemorrhage, infarction or toxicity
affects the entire cortex (glucocorticoid and mineralcorticoid deficiency)

36
Q

What causes secondary hypoadrenocorticism?

A
  • Inadequate ACTH secretion
  • Zona glomerulosa unaffected (only glucocorticoid deficiency)
37
Q

What causes iatrogenic hypoadrenocorticism?

A
  • Sudden discontinuation of corticosteroid therapy
  • temporary disease due to supression of ACTH secretion
  • only a glucocorticoid deficiency
38
Q

What is primary hyperaldosteronism (Conn’s syndrome)

A
  • Rare condition
  • Aldosterone producing adenoma
39
Q

What is secondary hyperaldosteronism?

A

Renin-angiotensin system activation due to chronic systemic
circulatory impairment (eg. right-sided heart failure)

40
Q

What is pheochromocytoma?

A

Neoplasia of the adrenal medulla

Dark- Colour-Tumour

41
Q

Why does Hyperadrenocorticism cause polyuria?

A

Cortisol decreases the sensitivity to ADH

42
Q

What is the effect of aldosterone on the renal tubules?

A
  • Increased Na+ excretion
  • Increased K+ excretion
43
Q

How does stress trigger glucocorticoids?

A
  • Stress = CRH from hypothalamus = ACTH from anterior pituitary = glucocortcoids from adrenal cortex
44
Q

What may adrenal haemorrhage cause?

A
  1. Exertional deaths in race horses
  2. Neonates/a bortion
  3. DIC
  4. septiceamia
45
Q

What is WFS an expression of in cows?

A

DIC in septicaemic cows= haemorrhagic adrenal necrosis

46
Q

What does excess ACTH secretion cause hyperstimulation of?

Pituitary dependent hyperadrenocorticism

A

The adrenal cortices and bilateral hyperplasia

47
Q

What does an adrenal dependent hyperadrenocorticism cause hypersecretion of?

A
  • Hypersecretion of cortisol by a functional adrenocortical tumour, excess cortisol suppresses ACTH secretion, resulting in a bilateral adrenocortical atrophy
48
Q

cortisol promotes…

What is the mechanism of steroid hepatopathy?

A
  • Cortisol promotes hepatic glycogenesis to remove excess glucose
49
Q

What can hyperadrenocorticism go on to cause?

A

Hyperglycaemia -> insulin antagonism and gluconeogenesis
* Predisposes to diabetes mellitus

Immunosuppression
* secondary infections in the skin/ urinary tract

Predisposed to vascular thrombosis and gall baldder mucocele

50
Q

What cell changes are induced by corticosteroid release?

A
  • Lymphpenia, eosinopenia
  • Monocytosis and neutrophillia
51
Q

What are the 4 things that occur with hypoaldosteronism?

A
  • Hyponatremia
  • Increased water excretion
  • Hyperkalaemia
  • Acidosis
52
Q

What may a pheochromocytoma cause?

A
  • May secrete catecholamines (adrenaline and noradrenaline)
  • Hypertension-> spontaneous haemorrhage
  • Tachycardia
  • Cardiac hypertrophy
  • Hyperexcitability

VMS 2007 (28 decks)

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