ENDOCRINOLOGY 4

Question 1

Answer 1

Question 2

-what are the 3 types of hyperadrenocorticism?
-which 2 are the most common?

Answer 2

-pituitary dependant (c)
-adrenal dependant
-iatrogenic (c)

Question 3

what are some (7) common signs of hyperadrenocorticism

Answer 3

-PUPD
-polyphagia
-panting
-abdominal distention
-flank alopecia
-hepatomegaly
-muscle weakness
-systemic hypertension

Question 4

what changes do you expect on haematology in hyperadrenocorticism?

Answer 4

-stress leukogram (SMILED)
-thrombocytosis
-mild erythrocytosis

Question 5

what changes do you expect on biochemistry in hyperadrenocorticism?

Answer 5

-increased ALP
-increased ALT
-hypercholesterolemia
-hypertriglyceridemia
-mild hyperglycemia
-increased bile acids

Question 6

what changes do you expect on urinalysis in hyperadrenocorticism?

Answer 6

-low USG
-protienuria
-risk of UTI

Question 7

what are 3 tests for hyperadrenocorticism?

Answer 7

urine cortisol: creatinine
ACTH stim
low dose dex duppression

Question 8

describe the results youd expect in UCCR testing for hyperadrenocorticism, along with its limitations

Answer 8

-normal rules out HAC
-high is not diagnostic [overly sensitive to other thing such as stress]

Question 9

how does the ACTH stimulation test work?
-describe results youd expect, along with limitations

Answer 9

-ACTH injected IV,,then cortisol measured at 0 & 1 hrs
-normal ACTH: healthy dog or adrenal HAC
-super low ACTH: iatrogenic HAC
-super high ACTH: other HAC

Question 10

how does low dose dexmathasone supression test work?
-describe the results youd expect in low dose dex supression testing for hyperadrenocorticism, along with its limitations

Answer 10

-administer dexmethasone IV, collect blood and measure cotisol before injection, then @4hrs, then @8hrs
-complete supression rules out HAC
-failure to suppress does not allow diagnosis

Question 11

once diagnosis of HAC is made, you should determine source of problem/which type it is. which tests can you use to do this?

Answer 11

-ACTH assay
-imaging (abdomen/head)

Question 12

ACTH assay is used to differentiate between pituitary and adrenal dependant ACTH.
-explain the results?

Answer 12

-adrenal HAC: low ACTH
-pituitary HAC: normal-high ACTH

Question 13

imaging of the abdomen/head can be used to differentiate between PDH and ADH. explain how

Answer 13

-PDH: bilateral adrenal gland enlargement
-ADH: one adrenal has a discernable mass, second one is small

Question 14

what is the only licensed product to treat canine HAC in UK
-how does it work?

Answer 14

trilostane (vetoryl)
[inhibits conversion of pregnolone to progesterone]

Question 15

how often to perform a recheck [of cortisol levels] once medication has been started for hyperadrenocorticism?

Answer 15

-@ 10-14 days
-then every 3 mo