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Year 1/2 > Digestion & Metabolism 2: Thyroid Diseases > Flashcards

Digestion & Metabolism 2: Thyroid Diseases Flashcards

1
Q

what is COLLOID?

A

COLLOID is present in THYROID & acts as PRECURSOR of THYROID HORMONES

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2
Q

FORMATION of THYROID HORMONES comes from ____ which we get through ____

formation is FACILITATED by WHAT enzyme? this is important because…

A

IODINE, DIET

ENZYME = THYROID PEROXIDASE
–> IMPORTANT because we can TARGET THIS ENZYME with DRUGS to SUPPRESS THYROID PEROXIDASE in HYPERTHYROIDISM

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3
Q

MOST of T3 and T4 in PLASMA will be….

when ACTIVATED…

A

BOUND TO PROTEINS in PLASMA

when PHYSIOLOGICALLY ACTIVATED, T3 and T4 ARE FREE

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4
Q

T____ is MORE active than T____

T3 is made in ___ by…

if we want to measure the ACTION of thyroid, we should measure…

A

T3 MORE ACTIVE THAN T4

T3 is made in PERIPHERY by DEIODINATION of T4

if we want to measure ACTION of thyroid = T4

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5
Q

NEGATIVE FEEDBACK cascade of THYROID? (5 steps)

A
  1. hypothalamus makes TRH
  2. stimulates PITUITARY to make TSH
  3. TSH acts on THYROID GLAND –> makes T3/T4
  4. LIVER makes PROTEINS BOUND TO MOST OF T3/T4
  5. but only T3/T4 FREE can cause NEGATIVE FEEDBACK
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6
Q

thyroid MAIN FUNCTION?

why can we see ANEMIA in HYPOTHYROIDISM

A

= INCREASE METABOLISM

anemia? = because THYROID INCREASES EPO PRODUCTION, so HYPOTHYROID = NOT ENOUGH EPO

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7
Q

5 MAIN thyroid hormone actions?

A
  1. STIMULATES PROTEIN SYNTHESIS
  2. STIMULATES CARB & LIPID METABOLISM
  3. STIMULATES EPO (making RBCs)
  4. STIMULATES BONE TURNOVER
  5. STIMULATES NEURAL & SKELETAL DEVELOPMENT
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8
Q

HYPERTHYROID DZ..

= definition?

commonality dogs vs. cats?

what AGE animals do we tend to see this in?

MOST COMMONLY caused by ___ ____, but possible to be caused by ___ yet this is ___

A

= CLINICAL CONDITION resulting from EXCESS PRODUCTION of T3/T4 by thyroid

CATS&raquo_space;»> DOGS

tend to see in MIDDLE AGE-OLD CATS

MOST COMMONLY caused by ADENOMATOUS HYPERPLASIA, but possible to be caused by CARCINOMA but this is RARE

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9
Q

T4 name?

T3 name?

A

T4 = THYROXINE

T3 = TRIIODOTHYRONINE

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10
Q

ADENOMATOUS HYPERPLASIA of the THYROID…

most common cause of…

see grossly..

A

MOST COMMON CAUSE OF HYPERTHYROIDISM

see MULTIFOCAL NODULES THROUGH GLAND

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11
Q

ID LESION & DZ

A

ADENOMATOUS HYPERPLASIA

HYPERTHYROIDISM

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12
Q

MOST cats that become HYPERTHYROID are >____ ____

A

> 8 YEARS

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13
Q

HYPERTHYROIDISM…

1 common & often MISTAKEN clinical sign? how do owners see this?

6 other clinical signs?

A

1 common clinical signs? = POLYPHAGIA
–> owners MAY NOT NOTICE ANYTHING

other clinical signs?
1. WEIGHT LOSS despite RAVENOUS
2. PU/PD
3. V+
4. D+
5. POOR COAT
6. BEHAVIOR CHANGES

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14
Q

PE on HYPERTHYROIDISM? (4)

WHAT IS THE MOST IMPORTANT????

A
  1. HYPERACTIVE/hard to examine
  2. THIN
  3. ABNORMAL CARDIAC AUSCULTATION
  4. PALPABLE THYROID GLAND!!!! MOST IMPORTANT
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15
Q

three CBC abnormalities in HYPERTHYROIDISM?

however, they’re OFTEN ____ seen

A
  1. MILD elevation in PCV
  2. INCREASED MCV
  3. STRESS LEUKOGRAM

however, they’re OFTEN NOT seen

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16
Q

CHEMISTRY changes in HYPERTHYROIDISM? (3)

what 2 VALUES can be ELEVATED if CONCURRENT RENAL DZ?

A
  1. ALP/ALT elevation
  2. HYPERGLYCEMIA from STRESS
  3. T4 HIGH

2 elevations in CONCURRENT RENAL DZ?
1. BUN
2. CREATININE

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17
Q

diagnosis to CONFIRM HYPERTHYROIDISM?

if this test result is NORMAL but we still SUSPECT DZ, what should we do?

if STILL NORMAL, then likely…

A

TOTAL T4 CONCENTRATION!!

if we still SUSPECT DZ, then REPEAT 1-2 WEEKS since HORMONE LEVELS FLUCTUATE

if STILL NORMAL, then likely NONTHYROIDAL ILLNESS

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18
Q

FREE T4 CONCENTRATION…

this CANNOT be used as a ___ test for HYPERTHYROIDISM

why?

A

SINGLE

can be ELEVATED FOR OTHER REASONS

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19
Q

THYROID SCINTIGRAPHY…

helps ID what?

in HYPERTHYROIDISM, can help find ___ ___

A

helps ID FUNCTIONAL THYROID TISSUE

in HYPERTHYROIDISM, can help find ECTOPIC TISSUE

20
Q

THREE DIAGNOSTICS we should perform for FELINE HYPERTHYROIDISM?

what 2 diagnostics can we reserve if ___ ___ is NORMAL?

A
  1. TOTAL T4
  2. CBC/CHEMISTRY
  3. UA

what 2 can we reserve if TOTAL T4 is NORMAL?
1. THYROID SCINTIGRAPHY
2. T3 SUPPRESSION TEST

21
Q

BEFORE treating, need to ask WHAT QUESTION?

the answer in HYPOTHYROIDISM should be…

A

DO I NEED TO TREAT OR NOT?

IN HYPOTHYROIDISM, SHOULD ALWAYS BE YES

22
Q

HYPERTHYROIDISM often associated with ___ ____

how does this occur? (3)

A

RENAL FAILURE

how does this occur?
1. ELEVATED T4 causes INCREASE in GFR

  1. when HYPERTHYROID TREATED, causes DECREASED T4 and therefore DECREASED GFR
  2. because cats usually having CONCURRENT KIDNEY DZ, this can then cause RENAL FAILURE
23
Q

HYPERTHYROIDISM treatment…

drugs will INHIBIT action of ____ ____, which is used to make…

2 names of drugs?

A

drugs will INHIBIT action of THYROID PEROXIDASE, which is used to make THYROID HORMONES

2 names?
1. METHIMAZOLE (TAPAZOLE)

  1. FELIMAZOLE
24
Q

METHIMAZOLE…

used to treat WHAT?

ADVANTAGES? (2)

DISADVANTAGES? (1)

SIDE EFFECTS usually seen… and are usually ___, as well as…
1.
2.

A

TREATS HYPERTHYROIDISM

ADVANTAGES?
1. AVAILABLE & INEXPENSIVE
2. can control AMOUNT of THYROID HORMONE PRODUCED, especially important if there’s SUSPECTED RENAL DZ

DISADVANTAGES?
1. owners have to PILL ANIMAL MANUALLY BID

SIDE EFFECTS usually seen within FIRST 3 MONTHS, and are usually GI, as well as…
1. HEPATIC TOXICITY
2. IMMUNE-MEDIATED

25
Q

3 ROUTES of ADMINISTRATION for METHIMAZOLE?

how long/often should we MONITOR for SIDE EFFECTS & if we need to CHANGE DOSE?

A
  1. PO
  2. LIQUID
  3. TRANSDERMAL

should monitor EVERY 2-3 WEEKS for FIRST 3 MONTHS for SIDE EFFECTS & DOSAGE

26
Q

when is THYROID SURGERY indicated? (2)

advantages? (3)

disadvantages? (3)

A

indications?
1. only if there’s a BIG/CYSTIC THYROID MASS
2. if we need to REMOVE WHOLE THYROID

advantages?
1. can be CURATIVE
2. NO LIFELONG MEDS
3. NO MONITORING BLOOD LEVELS

disadvantages?
1. COST
2. requires GA
3. can cause HYPOCALCEMIA because PARATHYROID CAN BE COMPROMISED

27
Q

I-131 treatment…

= what is it?

advantage? (1)

disadvantages? (2)

A

= RADIOACTIVE TREATMENT with RADIOACTIVE ISOTOPE OF IODINE that will be MORE READILY TAKEN UP BY NEOPLASTIC THYROID CELLS

advantages?
1. 1 SQ injection can be CURATIVE

disadvantages?
1. need to be AUTHORIZED to work with RADIOACTIVE MATERIALS, so animal needs to be HOSPITALIZED BY LAW ($$$)
2. animals can become HYPOTHYROID

28
Q

animals treated with I-131 for HYP__THYROIDISM lived ___ than when treated with METHIMAZOLE

A

HYPERTHYROIDISM, LONGER

29
Q

if a cat has HYPERTHYROIDISM but VARIABLE KIDNEY FUNCTION, then you should likely do a…

A

TRIAL for METHIMAZOLE

30
Q

CANINE HYPERTHYROIDISM…

commonality?

can be caused by… & MOST animals have ____ ___ at the time of presentation

often has ___ to ____ prognosis

A

RARE in dogs

can be caused by THYROID CARCINOMAS that are LARGE & INVASIVE; & MOST animals have CERVICAL MASSES at the time of PRESENTATION

often has POOR to GRAVE prognosis

31
Q

what is the MOST COMMONLY DIAGNOSED ENDOCRINOPATHY in the…

DOG?

CAT? in WHAT AGES?

A

DOG = CANINE HYPOTHYROIDISM

CAT = FELINE HYPERTHYROIDISM if MIDDLE to OLDER AGE

32
Q

CANINE HYPOTHYROIDISM…

commonality?

has HIGH incidence of ___ DIAGNOSIS

most COMMON cause is ___-mediated ___ of the THYROID GLAND

biopsy?

in NECROPSY, can sometimes see…

A

COMMON disease

HIGH incidence of FALSE DIAGNOSIS

usually IMMUNE-mediated DESTRUCTION of the THYROID GLAND

biopsy is NOT HELPFUL because IT WILL NOT TELL US FUNCTION

in NECROPSY, can sometimes see SEVERE THYROID ATROPHY (almost no thyroid left)

33
Q

2 NEOPLASMS that can cause CANINE HYPOTHYROIDISM?

often cause ____ ____ of the thyroid gland

but this is an ____ cause

A

2 NEOPLASMS..
1. CARCINOMA
2. SQUAMOUS CELL CARCINOMA

often cause NEOPLASTIC DESTRUCTION

UNCOMMON cause

34
Q

what DRUG can cause CANINE HYPOTHYROIDISM?

A

TMS

35
Q

CANINE HYPOTHYROIDISM..

occurs in WHAT aged dogs? & give specific range

tends to affect WHAT size dogs? give 2 breeds

intact/fixed dogs & sexes likely? (2)

A

occurs in MIDDLE-AGED dogs 4-10 YEARS

tends to affect MID-LARGE breed dogs…
1. GOLDEN RETRIEVERS
2. DOBERMAN PINSCHERS

SPAYED FEMALES & NEUTERED MALES LIKELY

36
Q

CANINE HYPOTHYROIDISM…

clinical signs tend to be ___

common UNIQUE clinical signs? (5) which finding is MOST COMMON?

can also see many ____ & ____ signs!

SOMETIMES, can see ____ signs!

A

clinical signs tend to be PROGRESSIVE

common UNIQUE clinical signs?
1. EXERCISE INTOLERANT
2. CONSTIPATION –> MOST COMMON
3. MENTAL DULLNESS
4. ANOREXIA
5. HEAT-SEEKING

can also see many DERMATOLOGIC & NEUROMUSCULAR signs!

SOMETIMES, can see REPRODUCTIVE signs!

37
Q

DERMATOLOGIC signs in CANINE HYPERTHYROIDISM? (4)

A
  1. DULL, DRY FLAKEY COAT
  2. SECONDARY PYODERMA
  3. SEBORRHEA
  4. SYMMETRIC ALOPECIA
38
Q

in INTACT FEMALES with HYPOTHYROIDISM, causes WHAT 2 signs?

A
  1. affects FERTILITY
  2. DECREASES LIBIDO
39
Q

CONGENITAL HYPOTHYROIDISM commonality?

A

RARE

40
Q

2 CARDIOVASCULAR signs in HYPOTHYROIDISM?

A
  1. BRADYCARDIA
  2. CARDIAC ARRHYTHMIAS
41
Q

MYXEDEMA COMA…

can be a sign associated with WHAT DZ?

commonality?

animals often present…

A

can be associated with HYPOTHYROIDISM

EXTREMELY RARE

animals often present COMATOSE/NEUROLOGICAL

42
Q

WHY is CANINE HYPOTHYROIDISM often OVER-DIAGNOSED?

what SHOULD be done?

A

people usually ONLY TEST TOTAL T4 and use that as DIAGNOSIS!

INSTEAD, should combine LOW TOTAL T4 with HIGH TSH

43
Q

ONE COMMON CBC finding in HYPOTHYROIDISM?

which value should we take MULTIPLE measurements of? why?

A
  1. HYPOCHOLESTEROLEMIA

take MULTIPLE measurements of TOTAL T4 because LOW T4 CAN BE PRESENT FOR MANY REASONS

44
Q

if you have to choose ONE thyroid test for HYPOTHYROIDISM, choose ___ ___ because it’s….

A

FREE T4 because it’s LESS AFFECTED BY NON-THYROIDAL DISEASE

45
Q

TSH test…

can be used to test for ____

if POSITIVE for that disease, expect HIGH/LOW TSH

BEST DIAGNOSIS for this when COMBINED with WHAT test & WHAT result for this disease?

A

TESTS FOR HYPOTHYROIDISM

if HYPOTHYROID –> TSH IS HIGH, A LOT OF SUPPRESSION

BEST HYPOTHYROIDISM DIAGNOSIS when COMBINED with TOTAL T4 BEING LOW

46
Q

what is the GOLD STANDARD for HYPOTHYROIDISM?

A

TSH-STIM TEST

Year 1/2 (139 decks)

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