Lectures 6-8 - Cushing's Flashcards
ACTH is produced where?
anterior pituitary
Types of Cushing’s
PDH
ADH
Iatrogenic
Atypical/Occult
Food Dependent
c/s of cushing’s
pupd, pendulous abdomen, dehydration, depression, muscle wasting and weakness, truncal alopecia, calcinosis cutis, exophthalmos, etc
What are the 4-5 P’s of cushing’s?
Polyphagia
Polydipsia
Pot belly
Polyuria
+/- panting
Zona glomerulosa produces?
SALT
MINERALOCORTICOIDS
ALDOSTERONE
Zona fasciculata produces?
SUGAR
GLUCOCORTICOIDS
CORTISOL
Zona reticularis produces?
SEX
ANDROGENS, SEX HORMONES
atypical cushing’s maybe???
Common signalment for ADH dogs?
small and large
mostly female
poodles, GSDs, dachshunds, labs, terriers, spaniels, malamutes
Common signalment for PDH?
smaller toy breeds <20kg
poodle, dachshund, beagles, bostons, schnauzers, GSDs
Age signalment for cushing’s
older
Is pseudomyotonia treatable?
no
What are the complications of Cushing’s?
UTI
recurrent infections
calcium oxalate urolithiasis
hepatobiliary disease
What is more common: PDH or ADH?
PDH
What level is ACTH in PDH?
INCREASED
What level is ACTH in ADH?
DECREASED
PDH does what with cortisol?
it ignores the adrenal gland’s negative feedback from excess cortisol
ADH does what with cortisol?
produces excess cortisol so pituitary stops making ACTH and adrenal keeps making cortisol
T/F: ADH is usually unilateral and has a 50/50 chance of being benign or malignant.
true
In which type of Cushing’s do you see micro and macroadenomas?
PDH
What should be your last phase of a cushing’s work up if your pt is neuro?
CT/MRI
What causes iatrogenic cushing’s?
exogenous intake of glucocorticoids
Most cats have what type of cushing’s?
PDH
Key c/s of cats with cushing’s
diabetes mellitus, alopecia, thin fragile skin, pupd, polyphagia, abdominal distention, muscle wasting
What is another DDx for cushing like symptoms in a cat?
lymphoma
50% of PDH cats have pituitary (micro/macro)adenomas.
macro
If your feline patient has concurrent cushing’s and unregulated diabetes mellitus, what happens with their weight?
loss
If your feline patient has concurrent unregulated diabetes mellitus with concurrent acromegaly, what happens with their weight?
gain
What clin path abnormalities will you see with cushing’s?
hyperglycemia, anemia, hypochloremia, hypertriglyceridemia, normal T4
Tx of Cushing’s in cats
surgery
radiation
trilostane
Iatrogenic Cushing’s has what levels of ACTH?
low
If you have a sick patient, what should you use to diagnose your patient with cushing’s?
ACTH stim
