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35 Cards in this Set
- Front
- Back
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What is the common name for hypoadrenocorticism? |
Addison's Disease |
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What are the three layers of the adrenal cortex? |
Zona glomerulosa (salt), zona fasiculata (sugar), zona reticularis (sex) |
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What is the main function of the zona glomerulosa? |
Secrete mineralocorticoids mainly aldosterone (sodium/water reabsorption from kidney) |
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What are the other two layers responsible for? |
cortisol and androgen hormone release |
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What is the main difference between the zonaglomerulosa and the other layers? |
Zona glomerulosa has an enzyme called aldosterone synthase to make aldosterone but lacks 17 alpha hydroxylase |
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Aldosterone's job... |
Sodium/water reabsorption, maintain hydration, euvolemia, potassium excretion |
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What is aldosterone's control mechanism? |
Plasma potassium and RAAS |
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What regulates cortisol? |
ACTH |
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What is addison's disease? |
inadequate production of glucocorticoids mainly cortisol by the adrenal glands |
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Most common addison's etiology? |
primary failure of the adrenal gland |
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Majority of the cases of addison's are... |
ideopathic |
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It is presumed that addison's happens due to... |
immune mediated disease |
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Addison's: young to middle age or old dogs? |
young to middle age |
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Addison's: purebred dogs or mutts? |
purebred dogs |
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If there is a secondary cause of addison's what structure does it involve? |
pituitary gland |
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What are some common breeds that get addison's and have an established inherited pattern? |
Standard poodle Portuguese water dog Nova scotia duck tolling retriever bearded collie |
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T/F: There is a strong male gender predisposition for addison's |
false - female! |
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A lot of dogs with addison's have GI signs. Why? |
Steroids promote normal blood flow to the GI mucosa causing intermittent vomiting, diarrhea, inappetence, GI bleeding occasionally |
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A lot of dogs with addison's have PU/PD. Why? |
Low aldosterone so wasting sodium and water, medullary wash out |
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T/F: Dog's with glucocorticoid and mineralocorticoid deficiencies have more severe signs. |
True |
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How might a dog with glucocorticoid and mineralocorticoid deficiency present? |
Hypovolemic shock |
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T/F: PE signs in Addisonian's are generally nonspecific |
True |
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What is the body's physiological response to hypovolemic shock? |
Heart rate and blood pressure should increase |
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If you encounter an animal that is in hypovolemic shock and has bradycardia what is your top differential? |
Addison's |
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T/F: Animal's with Addison's are often misdiagnosed for acute renal failure. |
True |
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What key findings lead clinicians to believe Addisonian patients have acute renal failure? |
Pre-renal azotemia, isothenuria, PU/PD, hyperkalemia |
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T/F: Animal's with Addison's are often misdiagnosed with GI disease |
True |
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Where do whipworms inhabitant the GI tract? |
cecum and proximal large bowel |
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T/F: Whipworms cause pseudo Addison's |
True --> large bowl diarrhea sodium and fluid loss |
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What two diagnostic results are similar in Addison's and GI? |
Sodium potassium ratio decreased |
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What are some key findings on radiograph for Addisonians? |
Hypovolemic shock (heart small and caudal vena cava difficult to see, lung lobes decreased blood flow, liver small), megaesophagus (1% of dogs) |
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What do you see on ECG of Addison's patient? |
no p waves, tall tented t waves, hyperkalemia cardiac toxicity |
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What is life saving in the majority of Addisonian patients? |
Address hyperkalemia with 0.9% saline to replace sodium load and reduce potassium concentrations |
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What is maintenance level of potassium? |
20 mEq/L |
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T/f: Even though saline is the fluid of choice could treat with almost ANY fluids just need to make sure you don't give potassium supplementation |
True |
