25 Questions
What is the most common age group in which Addison disease (hypoadrenocorticism) is seen?
Young to middle-aged dogs
What is the primary cause of adrenocortical failure in cases of Addison disease?
Autoimmune process
Why is isolated glucocorticoid insufficiency likely underdiagnosed?
As a result of vague and fluctuating clinical signs
What is required for confirming the diagnosis of hypoadrenocorticism?
Adrenal function testing using the ACTH stimulation test
Which of the following clinical signs is most commonly associated with isolated glucocorticoid insufficiency in older dogs?
Hypoalbuminemia
What is the principal mineralocorticoid whose reduction in secretion results in marked alterations of serum levels of potassium, sodium, and chloride?
Aldosterone
Which of the following ECG changes may occur in dogs with hyperkalemia?
Tall T wave
What is the most common abnormality in dogs with glucocorticoid and mineralocorticoid insufficiency?
Bilateral idiopathic adrenocortical atrophy
What does a sodium:potassium ratio of < 25:1 indicate in the evaluation of adrenal function?
Addison's disease
What is the suspected immune-mediated pathogenesis associated with idiopathic adrenocortical insufficiency in young, female adult dogs?
Antibody-mediated destruction of adrenal cortex cells
Which of the following may contribute to the development of moderate hypoglycemia in dogs with decreased production of glucocorticoids?
Decreased gluconeogenesis
'A destructive pituitary lesion that decreases ACTH secretion is characterized by severe atrophy of which part of the adrenal gland?'
Zona reticularis
What does a normocytic, normochromic anemia indicate in the evaluation of adrenal function?
Non-specific finding in Addison's disease
What is the main focus of successful treatment for hypoadrenocorticism?
Rapid restoration of blood volume
Which hormone is used for long-term maintenance therapy in dogs with hypoadrenocorticism?
Desoxycorticosterone pivalate (DOCP)
What should be administered if a dog with hypoadrenocorticism is hypoglycemic?
10% glucose in 0.9% saline
How often should serum electrolytes be monitored in dogs receiving fludrocortisone acetate for hypoadrenocorticism?
Weekly
What is the initial management of shock in dogs with hypoadrenocorticism?
Rapid restoration of blood volume
What hormone may be used to help with electrolyte imbalances and hypovolemia in dogs with hypoadrenocorticism?
Desoxycorticosterone pivalate (DOCP)
What test effectively excludes the diagnosis of hypoadrenocorticism if baseline cortisol concentrations are >2.0 mcg/dL?
ACTH stimulation testing
What is administered if a dog with severe, nonresponsive hyperkalemia requires increased potassium movement into the cells?
$10%$ glucose in $0.9%$ saline
What hormone should be administered if a dog is hypoglycemic and needs enhanced glucose and potassium uptake?
$10%$ glucose in $0.9%$ saline concurrently with regular insulin injection
What hormone specifically will not interfere with cortisol measurements during the ACTH stimulation test?
$Prednisolone sodium succinate or dexamethasone sodium phosphate
What is NOT true about the treatment of horses with hypoadrenocorticism?
Replacement of fluids, steroids, and glucose if needed is similar to that in dogs.
How often should dogs be reexamined after a diagnosis of chronic hypoadrenocorticism?
Every 3 months
Test your knowledge about Addison disease (hypoadrenocorticism), its clinical signs, diagnosis, and treatment. Explore the lack of glucocorticoids, mineralocorticoids, and the rarity of isolated aldosterone insufficiency. Understand the vague clinical signs, diagnosis challenges, and the importance of accurate history in diagnosis.
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