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Pathology II - Fall 2015 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Hyperadrenocorticism is AKA…

A

Cushing’s

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2
Q

Causes of Cushing’s…

A

Pituitary Adenoma

  • corticotroph
  • ACTH-secreting
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3
Q

Lesions associated w/ Cushing’s…

A

Steroid hepatopathy, calcinosus cutis, secondary infections, epidermal atrophy & alopecia, adrenal cortical hyper-/hypo-plasia

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4
Q

PPID is caused by…

A

pars intermedia pituitary adenoma

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5
Q

Lesions associated w/ PPID…

A

hirsutism, +/- adrenal cortical hyperplasia

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6
Q

Hypoadrenocorticism is AKA…

A

Addison’s

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7
Q

Addison’s is caused by…

A

primary atrophy (idiopathic following adrenalitis), secondary due to hypopituitarism (cyst, neoplasm), or exogenous steroids

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8
Q

Lesions associated w/ Hypopituitarism…

A

depends on the obliterated cell type

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9
Q

Hypopituitarism is caused by…

A

rathke’s pouch cysts, obliterating the pituitary

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10
Q

Growing animals w/ Hypopituitarism lack…resulting in…

A

lack GH…proportionate dwarfism

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11
Q

Compression or Destruction of the Neurohypophysis results in…

A

Diabetes Insipidus

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12
Q

What is the Pathological Process affecting the adrenal gland in a dog with MDx: adrenal cortical adenoma/carcinoma?

A

Disorder of Growth

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13
Q

Steroid hepatopathy, causing Cushing’s disease, is consistent with what Histological MDx?

A

Vacuolar hepatocellular degeneration - looks “ballooned out” w/ cytoplasmic vacuoles (Slide 18)

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14
Q

Chronic cortisol excess, or hyperadrenocorticism, is one of the most common endocrinopathies. What are the affects of chronic cortisol excess in animals?

A

Epidermal and follicular atrophy, hepatomegaly, hypertension, immunosuppression, poor wound healing, muscle atrophy, & PU/PD

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15
Q

Chuck, 7yo MN, poodle presents w/ a pot belly, alopecia, erythema, pustules and calcinosus cutis. What is your diagnosis?

A

Cushing’s

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16
Q

Normally, the Cortex: Medulla is….

A

1:1

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17
Q

Roughly 50% of adrenocortical neoplasms are malignant, yet they are…

A

non-productive.

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18
Q

A kitty names Jock presents w/ polymyopathy and hypertension. What is the disease name? What causes the polymyopathy?

A

Name: Conn’s Syndrome –> hyperaldosterism

Polymyopathy –> hypokalemia & hypernatremia

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19
Q

A ferret names Mickey presents with alopecia, anemia, prostatic hyperplasia and PU/PD. This ferret has an adrenal neoplasm w/ signs due to….His cortisol levels are…

A

Adrenal Neoplasm w/ signs due to hyperestrogenism….cortisol levels are normal.

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20
Q

A necropsied canine patient with CS’s - alopecia, PU/PD and polyphagia - appears to have adrenal glands with a cortex that is 4x the size of the medulla. What is your MDx?

A

adrenocortical hyperplasia

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21
Q

What is the most likely cause of adrenocortical hyperplasia?

A

Increased ACTH from the Pituitary that could be caused from a tumor.

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22
Q

What is a senile hyperplastic adrenal change?

A

Nodular adrenocortical hyperplasia

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23
Q

Corticotroph adenomas are comprised of cells that secrete…

A

ACTH

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24
Q

What percentage of canine Cushing’s patients are secondary or pituitary dependent?

A

85%

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25
Q

What percentage of canine Cushing’s patients are primary or adrenal dependent?

A

15%

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26
Q

In dogs, the majority of pituitary adenomas are (active/inactive) and from pars (intermedia/distalis).

A

In dogs, the majority of pituitary adenomas are active and from pars distalis.

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27
Q

In horses, most pituitary adenomas are from pars (intermedia/distalis) and (all/some) produce ACTH.

A

In horses, most pituitary adenomas are from pars intermedia and some produce ACTH.

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28
Q

A horse named Charlie presents w/ a pot belly, hyperhidrosis, PU/PD, abnormal fat deposition, and hirsutism. What is your diagnosis?

A

PPID - Pituitary Pars Intermedia Dysfunction

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29
Q

A new client brings her 5yo FS bichon frise that presents with PU/PD, bilaterally symmetrical alopecia, and a pot belly. You order an ACTH Stimulation Test and the results are

A

After further consult with the owner, you discover that the patient previously received a Depomedrol injection for allergies. This patient was given too many steroids creating IATROGENIC CUSHING’S DISEASE.

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30
Q

Pathogenesis of Iatrogenic Cushing’s…

A

Exogenous glucocorticoids suppress ACTH –> adrenocroticoatrophy –> HYPO-functional adrenal glands

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31
Q

Bilateral adrenocortical atrophy is caused by a reduction of mineralocorticoids and glucocorticoids. What is this process called?

A

Hypoadrenocorticism due to primary, immune-mediated, atrophy from lymphocytic adrenalitis.

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32
Q

If bilateral adrenocortical atrophy is caused by a reduction of aldosterone, the process is …

A

secondary.

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33
Q

Another canine pt. is found to have an adrenal tumor. The clinical signs are not those of Cushing’s. How do you distinguish the tumor from a pheochromocytoma or adrenocortical adenoma/carcinoma?

A

First, send it to a pathologist for Histo!
Adrenocortical tumors - yellow colored & greasy
Pheochromocytomas - come from adrenal medulla and secrete catecholamines - they are red!

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34
Q

Histologically, what are some characteristics of adrenocortical adenomas?

A

vacuoles where cells are storing steroids
poorly differentiated from adrenal gland
small, cuboidal cells w/ neuroendocrine appearance

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35
Q

When the anterior pituitary can stimulate the thyroid gland due to low T4 concentration, the result is…why?

A

thyroid hyperplasia
TSH from the anterior pituitary is stimulating the thyroid gland in the absence/low concentration of T4 - taking away feedback inhibition on the anterior pituitary

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36
Q

You are called out to a farm of 43 Boaer goats…
40 kids born dead/died shortly following birth
weak kids w/ large neck swelling
some hairless - aliens!
only 12 goats left to kid!
Necropsy shows a red/purple, meaty bilobed mass where the thyroid gland should be. What is the most likely Path. Process & MDx…Gross MDx and Disease Diagnosis?

A

MDx: thyroid hyperplasia
Path. Process - disorder of growth
Gross MDx: bilateral thyroid hyperplasia
Disease diagnosis: Goiter

37
Q

In comparison to bilobed masses, adenomas tend to be…

A

solitary masses.

38
Q

What does normal thyroid tissue look like histologically?

A

epithelial cells that make nice, round follicles with pink pyloid in the center

39
Q

What stimulus causes proliferation of thyroid follicular epithelial cells?

A

TSH

40
Q

What affect does thyroxine have on the Anterior Pituitary?

A

decreased T4 –> Negative Feedback on the Ant. Pituitary –> decrease TSH secretion –> decrease thyroid gland stimulation –> produce more thyroxine

41
Q

To get thyroid hyperplasia, you need increased TSH stimulating the thyroid gland. Increased TSH occurs when…q

A

T4 is low, due to loss of feedback inhibition

42
Q

What are the things that decrease T4/increase TSH?

A

Iodine deficient diet
Goiterogenic substances
Congenital dyshormonogenic goiter
excess dietary iodide

43
Q

What are goiterogenic substances and what do they do?

A

Goiterogenic substances are: plants/drugs that interfere w/ thyroxine/thyroglobulin production by screwing up their enzymes

44
Q

Congenital dyshormonogenic goiter is an…

A

autosomal recessive defect in the enzymes required to make thyroglobulin (Tg)

45
Q

How can you tell if the thyroid gland is hypo functional?

A
  • CS reflecting hypothyroxine
  • T4 & TSH levels
  • lesions - atherosclerosis or bilaterally symmetrical alopecia
46
Q

A cat, Marmaduke, presents with weight loss w/ an increased appetite, PU (EVERYWHERE!), and driving the owner coo-coo for cocoa puffs! Upon PE, you find enlarged nodular thyroids. What is the most likely Pathological Process?

A

disorder of growth

47
Q

A cat, Marmaduke, presents with weight loss w/ an increased appetite, PU (EVERYWHERE!), and driving the owner coo-coo for cocoa puffs! Upon PE, you find enlarged nodular thyroids. What is the normal shape of the thyroid gland?

A

smooth, in shape

48
Q

The Histopathology report from Marmaduke, a cat with weight loss w/ an increased appetite, PU (EVERYWHERE!), and driving the owner coo-coo for cocoa puffs comes back as thyroid hyperplasia or nodular/adenomatous hyperplasia. What is the MDx?

A

Nodular (“adenomatous”) thyroid hyperplasia

49
Q

T/F - Thyroid lesions in cats are mostly malignant.

A

False - In cats, most thyroid lesions are benign.

50
Q

T/F - Most proliferative thyroid lesions in cats are productive.

A

True!

51
Q

What are the lesions underlying Hyperthyroidism in cats?

A
  • adenomatous hyperplasia/adenoma (in most cases)

- carcinoma (

52
Q

A friend Facebook messages you about his black lab that is “breathing funny”. You go over and perform a PE, finding a mass on the dog’s neck. You take him to your hospital, test his T4 and find it to be euthyroid. Path. Process? Gross MDx? Prognosis?

A

Path. Process: Disorder of Growth
Gross MDx: thyroid follicular carcinoma
Prognosis: Bad! Very, very bad!

53
Q

The term “Goiter”means…

A

thyroid enlargement with the inability to produce thyroid hormone

54
Q

A 3 month old dalmation was found dead this morning. After some tests you find that the pup had renal failure, hypercalcemia, and a swollen maxilla. Necropsy shows large, nodular parathyroid glands approximately 8x the normal size. What is your MDx? Path. Process? What’s up with the Renal disease?

A

MDx: multifocal parathyroid hyperplasia
Path. Process: Disorder of Growth
Renal Disease is congenital.

55
Q

Secondary hyperparathyroidism will…

A

increase PTH secretion for the parathyroid gland.

56
Q

What is the #1 cause of secondary hyperparathyroidism?

A

Renal Failure

57
Q

What are the ways to increase PTH?

A

Primary hyperparathyroidism - PTH producing parathyroid neoplasm (adenoma»Carcinoma)
& pseudo-hyperparathyroidism

58
Q

3 outcomes/complications of diabetes mellitus…

A

cataracts
hepatic lipidosis
microangiopathy

59
Q

Most likely cause of diabetes mellitus in dogs…

A

pancreatitis

60
Q

Type I Diabetes Mellitus is found in…

A

dogs.

61
Q

Type II Diabetes Mellitus is found in…

A

cats.

62
Q

What ways can PTH be increased?

A

primary hyperparathyroidism
pseudo-hyperparathyroidism
secondary hyperparathyroidism

63
Q

Hypoparathyroidism is uncommon and caused by…

A

veterinarians who f*** up! It is Iatrogenic. Usually occurs when we want to remove the thyroid gland and accidentally remove the Parathyroid gland along with it.

64
Q

Candy, a 7yo FS poodle mix, presents dead. She recently has been “zoned out”, weak, and recently developed seizures. Your PM findings include a small, 1.5cm in diameter, mass on the pancreas. Her brain shows deranged cortical neurons (that explains the seizures!). What is the Path. Process? Gross MDx?

A

Path. Process: disorder of growth

Gross MDx: pancreatic adenoma/pancreatic carcinoma

65
Q

What cells are pancreatic adenomas/carcinomas derived from?

A

islet cells –> Beta cells predominantly

exocrine/digestive cells

66
Q

Candy’s brain was submitted for Histopathology. The Histo report MDx: acute cerebral cortical neuronal necrosis. What is this likely a result of?

A

Likely a result of hypoglycemia resulting from an insulin producing Beta-cell tumor producing too much Insulin - requires immunohistochemistry to confirm if it is insulin-producing.

67
Q

What cells secrete glucagon?

A

Alpha cells of the pancreas.

68
Q

What cells secrete insulin?

A

Beta cells of the pancreas.

69
Q

T/F - Most pancreatic islet cell tumors are endocrinologically active.

A

True!

70
Q

T/F - Most pancreatic islet cell tumors are insulin-secreting beta-cell tumors.

A

True!

71
Q

T/F - Most islet cell tumors are benign.

A

False! Most islet cell tumors are malignant!

72
Q

Diabetes mellitus is a clinical syndrome of….

A

hypoinsulinism.

73
Q

What 3 conditions lead to insulin resistance?

A

hyperadrenocorticism
obesity
pregnancy

74
Q

What is the pathogenesis of Diabetes Mellitus due to Insulin resistance in a cat?

A

insulin resistance –> long term overstimulation of Beta cells –> intracellular accumulation of glycogen –> vacuolar degeneration of beta cells –> insulin deficiency and more severe diabetes mellitus

75
Q

T/F - Cats with or without Diabetes Mellitus can have islet amyloidosis.

A

True!

76
Q

What are the Clinical signs of Diabetes Mellitus?

A

polyphagia, PU/PD, and weight loss

77
Q

What lesions are associated with Diabetes Mellitus?

A

cataracts, hepatic lipidosis, microangiopathy, and various lesions caused by infections

78
Q

Manifestations of microangiopathy…

A

diabetic retinopathy and gangrene

79
Q

What is the pathogenesis of diabetic nephropathy due to diabetes mellitus?

A

chronic hyperglycemia –> formation of glycosylated proteins –> deposition into capillary basement membranes –> thickened basement membranes (microangiopathy)

80
Q

What is the pathogenesis of cataracts in a dog with diabetes mellitus?

A

excessive glucose is taken up by epithelium of the lens –> metabolized to sorbitol by aldose reductase –> sorbitol osmotically draws water into the lens –> cataract formation

81
Q

What is the most common tumor in ferrets?

A

Insulinoma

82
Q

What lesions can cause diabetes mellitus?

A

beta cell degeneration
beta cell amyloidosis
islet-itis
chronic pancreatitis

83
Q

T/F - Acute and chronic pancreatitis can lead to diabetes.

A

True.

84
Q

Cats with diabetes mellitus is commonly a cause of insulin…

A

antagonism.

85
Q

What is the Pathological process of diabetes mellitus due to insulin antagonism in cats?

A

degeneration/necrosis - due to chronic hyperglycemia associated w/ insulin antagonism

86
Q

What is the MDx of diabetes mellitus due to insulin antagonism in cats?

A

Pancreatic Islet Cell Vacuolar Degeneration

87
Q

Histo of a cat pancreas from a pt. with diabetes mellitus shows eosinophilic, homogenous, glassy substances that have wiped out and replaced the normal islet cells. What is the substance? Path. Process? MDx?

A

Substance: amyloid
Path. Process: Deposits & Pigmentation
MDx: Pancreatic islet amyloidosis

88
Q

What is the pathogenesis of Pancreatic Islet Amyloidosis?

A

long term over-stimulation of Beta cells –> Beta cells produce IAPP (islet amyloid polypeptide) along w/ insulin –> IAPP polymerize to form amyloid –> crowding of islet cells –> islet cell atrophy –> insulin deficiency and more sever diabetes mellitus

89
Q

Cataracts in a dog with diabetes is caused by…

A

the uptake of glucose by lens epithelium. Water osmotically follows the glucose causing opacity of the lens = cataracts.

Pathology II - Fall 2015 (5 decks)

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