P34 - Adrenal Gland Flashcards
cortisol inhibits ___ and ___ resulting in a negative feedback
- CRH
- ACTH
hyperadrenocorticism is also know as _____ and what 3 things can increased levels be due to
- Cushing’s disease
- pituitary-dependent hyperadrenocorticism (PDH)
- functional adrenocortical neoplasm (FAN)
- stress-induced adrenocortical hyperplasia
primary hypoadrenocorticism is also known as
- Addison’s disease
iatrogenic adrenal disorders are due to what
- actions of medical personal
- can be increased or decreased
PDH pituitary neoplasm pathogenesis and clinical signs and will it respond to negative feedback
- producing more ACTH -> adrenocortical hyperplasia (bilateral) -> increase cortisol production and aldosterone - Cushnoid clinical signs
- will not respond to negative feedback
FAN pathogenesis, clinical signs and will it respond to negative feedback
- neoplastic adrenocortical cells -> increase cortisol and aldosterone
- Cushnoid clinical signs
- negative feedback is created (less CRH and ACTH)
stress-induced adrenocortical hyperplasia pathogenesis and clinical signs
- stress (chronic) -> ACTH -> adrenocortical hyperplasia (bilateral) -> increase cortisol and aldosterone
- cushnoid signs not expected
primary hypoadrenocorticism pathogenesis and clinical signs
- bilateral adrenocortical hypoplasia -> decrease cortisol and aldosterone -> electrolytes change
- ACTH increased
- Addisonian clinical signs
iatrogenic hyperadrenocorticism -> hypocortisolemia due to; pathogenesis and clinical signs
- prednisone or other glucocorticoids
- inhibits CRH and ACTH -> bilateral hypoplasia -> decrease cortisol and aldosterone
- cushnoid clinical signs
iatrogenic hypoadrenocorticism -> hypocortisolemia due to abrupt cessation of treatment of prednisone or other glucocorticoids pathogenesis and clinical signs
- increase CRH and ACTH -> bilateral hypoplasia -> decrease cortisol and aldosterone
- addisonian clinical signs
iatrogenic hypoadrenocorticism -> hypocortisolemia due to adrenal neoplasm or pituitary neoplasm pathogenesis and clinical signs
- lysodren -> destroys cells producing cortisol and aldosterone -> kill off too many -> state of hypoadrenocortiscism
- before treatment - cushnoid
- after treatment - addisonian
diagnostic method to confirm hypoadrenocorticism (addison’s) in a dog
- ACTH stimulation test
- no response -> solid support you have hypoplastic adrenal glands
dog presents like Addisonian and ACTH stimulation test has no decrease [ACTH] - is it primary or secondary
- primary
dog presents like Addisonian and ACTH stimulation test has decrease [ACTH] - is it primary or secondary
- secondary
cat presents like Addisonian and ACTH stimulation test has increase [ACTH] - is it primary or secondary
- primary
diagnostic method to confirm hyperadrenocorticism (cushing’s)
- urine cortisol:creatine ratio
- ACHT stimulation test
- dexamethasone suppression test
amount of creatine excreted per day is nearly constant -> an increase reflects increase urinary excretion of ____
- cortisol
Cort:Crt - WRI - interpretation
- does not have hyperadrenocorticism
Cort:Crt - increased - interpretation
- may or may not have hyperadrenocoriticism
low dose dexamethasone suppression test outcomes if healthy (suppress, not suppress, suppressed and escape)
- suppresses
low dose dexamethasone suppression test outcomes if PDH (suppress, not suppress, suppressed and escape)
- 72% do not suppress
- 26% suppress and escape
low dose dexamethasone suppression test outcomes if FAN (suppress, not suppress, suppressed and escape)
- 100 % do not suppress
low dose dexamethasone suppression test outcomes if nonadrenal disorders (suppress, not suppress, suppressed and escape)
- 50% suppress
- 50% do not suppress
if clinical signs (cushnoid) and no suppression of low dose dexamethasone suppression test most likely diagnosis
- hyperadrenocorticism
