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Diseases and Diagnosis > Block 7 > Flashcards

Block 7 Flashcards

1
Q

What is hyperadrenocorticism?

A

Cushings

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2
Q

Is canine or feline cushings common?

A

Canine

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3
Q

What does HAC mostly cause?

A

Hypercortisolemia

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4
Q

What can HAC also cause?

A

Technically refers to overproduction of any adrenocortical hormone
Sex hormones
Aldosterone

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5
Q

What are the layers of the cortex of the adrenal gland

A

Mineralcorticoids (salt)
Glucocorticoids (Sugar)
Androgens (Sex)

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6
Q

What are 2 mineralcorticoids?

A

Aldosterone and corticosterone

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7
Q

What are 2 glucocorticoids?

A

Cortisol and cortisone

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8
Q

What are 2 androgens?

A

Testosterone and estrogen

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9
Q

Where does steroid synthesis occur?

A

In adrenal cortex

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10
Q

What does steroid synthesis begin with?

A

Cholesterol

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11
Q

What are the 3 parts to the HPA axis?

A

Hypothalamus
Pituitary
Adrenal gland

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12
Q

What is the negative feedback on BOTH the pituitary and the hypothalamus?

A

Cortisol

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13
Q

What is released by the hypothalamus that stimulates the pituitary?

A

CRH (corticotropin releasing hormone)

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14
Q

What is released by the pituitary that stimulates the adrenal glands?

A

ACTH (corticotropin)

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15
Q

How many mechanisms of cortisol excess are there?

A

3

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16
Q

What are the 3 mechanisms?

A

Pituitary dependent HAC (PDH)
Adrenal dependent HAC (ADH)
Iatrogenic

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17
Q

What determines which mechanism it is?

A

Where the primary tumor is

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18
Q

What percent of HAC is PDH?

A

85%W

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19
Q

What type of tumor are most tumors?

A

Microadenomas

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20
Q

What size are macroadenomas?

A

> 1cm

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21
Q

What can macroadenomas cause?

A

Neurologic signs

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22
Q

What is the signalment of dogs with Cushings?

A

Middle to older age dogs

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23
Q

What percent of dogs are older than 6 yo?

A

100%

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24
Q

What percent of dogs are older than 9 yo?

A

90%

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25
Q

What percent of dogs with PDH are <20kg?

A

75%

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26
Q

What are the clinical symptoms of Cushings?

A

***PPPP
PU/PD
Polyphagia
Pot belly
Panting

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27
Q

What does cortisol cause to muscles?

A

Causes muscle weakness

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28
Q

What happens to the liver in HAC?

A

Enlarged liver

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29
Q

What causes the pot belly appearance of HAC?

A

Muscles of abdomen weaken and the liver enlarges so the liver falls into the abdominal space

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30
Q

What is another harmful result of muscle weakness in HAC dogs?

A

Potential for cranial cruciate tears

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31
Q

What are 4 dermatologic changes wth HAC?

A

Alopecia (non-pruritic)
Comedones
Hyperpigmentation
Calcinosis cutis

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32
Q

What is normally seen on CBC for HAC?

A

Stress leukogram
Thrombocytosis

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33
Q

What things are increased on chem for HAC?

A

ALP
ALT
GGT
Cholesterol

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34
Q

What crystals may you find on a UA?

A

Calcium oxalate or struvite

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35
Q

Why will T4 be low in a HAC patient?

A

Cortisol suppresses T4 so it will be low!
Dont diagnose hypothyroid!!

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36
Q

What are the 3 screening tests of HCR?

A

UCCR - urine cortisol:creatinine ratio
ACTH stim
Low-dose dex suppression

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37
Q

What is UCCR good for?

A

Ruling disease out!

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38
Q

Where should urine for UCCR be taken?

A

At home as to not stress the dog out and in the morning

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39
Q

What is the synthetic cortisol given in ACTH stim?

A

cosyntropin

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40
Q

What are steps to ACTH stim?

A

Give cosyntropin
Take ACTH cortisol 1 hour after

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41
Q

What result would not be in line with HAC?

A

<17 increase

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42
Q

What result is borderline increase for HAC?

A

17-22

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43
Q

What result is in line with HAC?

A

> 22

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44
Q

What can you not differentiate with a ACTH stim?

A

ADH vs PDH

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45
Q

How do you perform an LDDS?

A

Get a baseline cortisol
Administer dex
Obtain 4 hr levels
Obtain 8 hr levels

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46
Q

What is beneficial about LDDS?

A

It can differential between ADH and PDH

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47
Q

What do you look at first when reading an LDDS?

A

8 hr

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48
Q

Are there a lot of false negatives in LDDS?

A

No

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49
Q

What is a big con of LDDS?

A

Takes a long time

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50
Q

Are there a lot of false positives with LDDS?

A

Yes

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51
Q

What does LDDS test for?

A

PDH

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52
Q

What is another way besides LDDS to determine type of HAC?

A

Imagine (CT, US, MRI)

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53
Q

What is most important part of measuring the size of adrenal glands on ultrasound?

A

The thickness of the caudal poles?

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54
Q

Length doesn’t provide much information

A
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55
Q

What is normal adrenal size of dog?

A

4-5mm

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56
Q

If dog has cortisol-secreting adrenal mass, other adrenal gland should be small

A
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57
Q

Should endogenous ACTH be low or high in ADH dogs?

A

Low

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58
Q

How do you collect blood for endogenous ACTH measurement?

A

INTO CHILLED TUBE!

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59
Q

Cushings disease is a ______ disease

A

Clinical (clinical signs + clinicopathologic findings)

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60
Q

In feline HAC, what steroids are elevated?

A

Cortisol and aldosterone

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61
Q

What are 2 clinical signs that are different in cats than dogs with HAC?

A

Can come from poorly regulated diabetes mellitus
Cat skin can be very fragile

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62
Q

What test should not be used to screen feline Cushings?

A

ACTH stim

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63
Q

What test is considered the best screening test for feline Cushings?

A

LDDS test

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64
Q

What are 2 affects of the increased aldosterone?

A

Hypokalemia
Hypertension

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65
Q

What is the scoring system for Cushings and owners?

A

ALIVE score

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66
Q

Is higher or lower better for the ALIVE score?

A

lower the better

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67
Q

What should you do if there is a high blood pressure?

A

Fundic exam

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68
Q

What will you see on a cushing CBC?

A

Stress leukogram and thrombocytosis

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69
Q

What is a stress leukogram?

A

lymphopenia
Eosinopenia
monocytosis
neutrophilia

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70
Q

What causes the high potassium in Cushing chems?

A

The thromobocytosis

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71
Q

What will you see on the chem of Cushings?

A

Thrombocytosis
High ALT and ALP
Hypercholestrolemia
Hyperglycemia

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72
Q

What may you see on a Urinalysis for Cushings?

A

Low SG, high proteins

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73
Q

What is normal value for UPC (urine protein:creatinine)

A

<0.5

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74
Q

What might you see in the gallbladder of a Cushing dog?

A

Mucocele

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75
Q

What can HAC do to the liver?

A

Enlargement

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76
Q

What is the reference range for “not consistent with” in ACTH stim?

A

Post-ACTH cortisol <22

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77
Q

What type of HAC does LDDS test for?

A

PDH

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78
Q

What is SDMA a marker for?

A

Marker of GFR (kidney function)

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79
Q

What are 4 things that cause PUPD?

A

CKD
Cushings
Hepatic encephalopathy
pyometra

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80
Q

What is the cut off for LDDS at 8 hrs to be considered for HAC?

A

1.3

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81
Q

In a CBC, should cholesterol be high or low in HAC dogs?

A

Hypercholesterolemia

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82
Q

Describe liver findings of a dog with HAC

A

Heptomegaly
Hyperechoic liver

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83
Q

What is the threshold for diagnosis of HAC?

A

At least 3 consistent clinical signs and/or physical exam findings

At least 2 consistent clinpath findings

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84
Q

What is the definition of hypoadrenocorticism?

A

Decreased production of one or more adrenocortical hormone

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85
Q

What is the most common pathophysiology of Addison’s?

A

Primary immune mediated destruction of both adrenal glands

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86
Q

What is the more rare secondary pathophysiology of Addison’s?

A

Rare destruction of pituitary gland

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87
Q

What is typical Addison’s?

A

Glucocorticoid and mineralcorticoid deficiency

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88
Q

What is atypical Addison’s?

A

Just glucocorticoid deficiency

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89
Q

What age dogs get Addison’s?

A

Young to middle aged dogs

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90
Q

What is the median age of Addison’s?

A

4 years old

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91
Q

What is the sex predisposition of Addison’s?

A

Female (70%)

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92
Q

What are 2 breeds predisposed to heritable Addison’s?

A

Standard poodle and Portuguese water dog

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93
Q

What may trigger an Addison’s event?

A

A stressful event

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94
Q

What are some GI clinical signs of Addison’s?

A

Vomiting, diarrhea, anorexia, lethargy, weight loss

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95
Q

What are additional clinical signs of Addison’s?

A

Hypovolemic shock, collapse, NEVER PU/PD

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96
Q

What are some physical exam findings of Addison’s?

A

Weight loss, dehydration, abdominal pain, melena, bradycardia, hypotension

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97
Q

Does Addison’s have a stress leukogram?

A

NO!

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98
Q

***What is seen in the biochem?

A

Azotemia
Hypocholesterolemia
Hypoglycemia
Hypercalcemia
High globs, low albs

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99
Q

What occurs to liver enzymes with Addison’s?

A

Mild elevation

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100
Q

***In typical Addison’s, what additional chem values will you see?

A

Low bicarb
Hyponatermia
Hypochloremia
Hyperkalemia

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101
Q

What is a normal Na:K ratio?

A

27:1 - 40:1

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102
Q

What Na:K ratio is indicative (but not pathognomonic) of Addison’s?

A

<27:1

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103
Q

What occurs to lymphocytes in Addisons?

A

They are normally high!

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104
Q

What can cause the hyperkalemia to be an artifact?

A

Thrombocytosis may cause a pseudohyperkalemia

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105
Q

If measured using plsma, platelets have granules with Potassium so if blood is put in red top tube, you rely on platelets to activate and form clots. Once activated they will release potassium. With potassium, there is no clot so potassium is not released causing the pseudohyperkalemia!

A
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106
Q

Lymphocytes can also be artifactually high from younger animals (<6m), infectious disease, and neoplasia

A
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107
Q

What is the screening process to rule out Addison’s?

A

Basal or “resting” cortisol
Doesn’t rule it in but will rule it out

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108
Q

Proceed to ACTH stim test if the resting cortisol is lower than ____?

A

<2 (>2 its unlikely Addison’s)

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109
Q

How do you diagnose Addison’s?

A

ACTH stim?

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110
Q

How do you perform ACTH stim?

A

Give Cortrosyn
Measure 1-hour post cortisol

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111
Q

How do you diagnose ACTH stim?

A

If after an hour the ACTH-cortisol is still <2

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112
Q

Do cats get Addison’s?

A

NO (yes but very rare)

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113
Q

How do you determine typical vs atypical Addison’s?

A

Look at Na:K ratio

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114
Q

If already determined that K was WNL, the Na:K ratio will determine if it is typical or atypical Addison’s. What is typical, what is atypical?

A

Typical: <27 Na:K
Atypical: >27 Na:K

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115
Q

Can Addison’s cause Megaesophagus?

A

YES!!!

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116
Q

Is Pu/PD a sign of hypothyroidism?

A

NO!

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117
Q

What are 3 clinical signs of hypothyroidism?

A

Alopecia, pyoderma, and lethargy

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118
Q

What percent of dogs have primary hyperthyroidism?

A

> 95%

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119
Q

What is primary hypothyroidism caused by?

A

Lymphocytic plasmacytic thyroiditis or
idiopathic thyroid atrophy

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120
Q

What percent of the thyroid must be destroyed before clinical symptoms?

A

75%

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121
Q

What are 2 predisposed breeds for lymphocytic plasmacytic thyroiditis?

A

Beagles and borzois (BB)

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122
Q

Thyroid neoplasia is NOT a common cause of primary neoplasia

A
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123
Q

***Secondary hypothyroidism is very uncommon, what is most common cause of it?

A

Suppression of TSH by exogenous or endogenous glucocorticoids

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124
Q

What is the normal age range for hypothyroid dogs?

A

2-6 (middle to older dogs)

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125
Q

What breed of dog is hypothyroid rare in?

A

Toy breeds
German Shephards

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126
Q

What are 3 most common clinical findings of hypothyroid dogs?

A

Lethargy/inactivity
Weight gain w/o change in diet
Hyperkeratosis

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127
Q

What are the external physical exam findings “endocrine alopecia”?

A

Hyperkeratosis
Seborrhea (dandruff)
Thin hair
Rat tail
hyperpigmentation

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128
Q

What is a facial clinical sign?

A

“Tragic” facial expression due to myxedema (swelling of skin)

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129
Q

What is the main chem finding of hypothyroidism?

A

Hypercholesterolemia

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130
Q

What is the main cbc finding of hypothyroidism?

A

Non regenerative anemia

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131
Q

Hypothyroidism is a disease of clinical disorder. Patient needs clinical disorder and need something to improve to help monitor if there is improvement

A
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132
Q

What is sent to the pituitary from the hypothalamus?

A

TRH

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133
Q

What is sent to the thyroid from the pituitary?

A

TSH

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134
Q

What breed of dogs have lower T4 levels?

A

Sighthound

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135
Q

What is a Total T4 test used for?

A

To rule out hypothyroid (sensitive)

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136
Q

What is the most accurate thyroid test for diagnosis?

A

Free T4 ED (equilibrium dialysis)

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137
Q

What does the TSH test confirm?

A

Primary hypothyroidism

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138
Q

Should you use TSH test by itself?

A

NO!

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139
Q

What will be the result of the TSH test if its primary hypothyroidism?

A

High TSH and low T4

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140
Q

What does high autoantibodies suggest?

A

Primary hypothyroidism

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141
Q

What is the gold standard test for hypothyroidism?

A

TSH response test

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142
Q

With the TSH response test, prior treatment with T4 can fuck up results for 2 months after so do it right the first time

A
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143
Q

What results do you see with TSH response test if its hypothyroidism (administer TSH and check for response)

A

No response to TSH after 6 hours

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144
Q

Dogs get _____ Cats get ______

A

Dogs get hypothyroidism, cats get hyperthyroidism

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145
Q

What sex of cat gets hyperthyroidism more?

A

No sex predolection

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146
Q

What age cats get it more often?

A

Older cats

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147
Q

What is the #1 clinical sign of hyperthyroidism?

A

Weight loss

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148
Q

***What are other clinical signs of hyperthyroidism?

A

Polyphagia with weight loss
PU/PD
GI issues
Increased activity

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149
Q

People are often happy that their elderly cat is running around and acting like a kitten again

A
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150
Q

What is the apathetic form with hyperthyroidism?

A

Cat looks and feels ill
May be associated with concurrent disease

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151
Q

What clinical signs are there with apathetic form?

A

Lethargic, decreased activity and appetite, weakness

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152
Q

what are physical exam findings of hyperthyroid?

A

Thyroid slip
Thin
Poor hair coat
Systolic murmur
Tachycardia
Hyperactivity
Hypertension

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153
Q

What is an important step when you have a hyperthyroid cat with hypertension?

A

Fundic exam

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154
Q

What is a reliable screening test for Hyperthyroid/

A

Total T4

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155
Q

What are the 2 most reliable things seen on chem of hyperthyroid cats?

A

***Liver enzyme increase - ALT!
Azotemia

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156
Q

***What can be masked due to hypertension and increased GFR in old cats?

A

Kidney disease

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157
Q

What should you always run for hyperthyroid cats to unmask CKD?

A

UA (<1.035 is concerning)

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158
Q

What can you run to get an early detection that is not affected by muscle mass in hyperthyroidism?

A

SDMA

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159
Q

What is the best test to look for masked CKD (SDMA or USG)?

A

USG <1.035

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160
Q

You should use both the USG and SDMA values to increase the likelihood that you are correctly diagnosing masked CKD

A
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161
Q

What may be seen on CBC for hyperthyroid cats?

A

Increased PCV and MCV

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162
Q

What may be seen on radiographs of a cat with hyperthyroidism?

A

Cardiomegaly

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163
Q

What is the best test to use for diagnosing hyperthyroidism?

A

increasing T4 with baseline

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164
Q

What is most affected by illness severity?

A

T4

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165
Q

What is a radiological approach to diagnosis?

A

Nuclear scintigraphy

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166
Q

What are the thyroids compared to in nuclear scintigraphy?

A

The salivary gland

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167
Q

What ratio indicates hyperthyroid in nuclear scintigraphy?

A

> 2:1 with the salivary glands

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168
Q

What will happen in normal physiology with administration of T3?

A

A decrease in TT4

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169
Q

What happens if you administer T3 to a hyperthyroid cat?

A

TT4 will remain the same “T3 suppression test”

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170
Q

What 4 drugs have the potential to affect thyroid function?

A

Glucocorticoids
Phenobarbitals
Sulfonamides
NSAIDs

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171
Q

What is a functional pituitary neoplasm

A

Tumor that causes an overproduction of hormones

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172
Q

What is a nonfunctional pituitary neoplasm?

A

Tumor that doesnt cause a release of hormones

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173
Q

What 2 domestic species most frequently devlope pituitary neoplasms?

A

Dogs and horses

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174
Q

What are the clinical signs of PPID primarily caused by?

A

Compression of normal pituitary/hypothalamus

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175
Q

For horses it is the pituitary adenoma of the pars ______

A

Intermedia

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176
Q

For dogs it is the pituitary adenoma of the pars _____

A

distalis

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177
Q

What is the ACTH secreting adenoma/

A

Pars distalis

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178
Q

What is adenoma of the pars distalis called?

A

Canine cushings

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179
Q

What is adenoma of the pars intermedia called in horses?

A

Equine cushings

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180
Q

In rats with an adenoma of the pars distalis, what hormone is increased?

A

Prolactin

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181
Q

What does the increased prolactin levels in the rat cause?

A

Potential for increased mammary neoplasias

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182
Q

Of the adrenal gland, what is the negative feedback to the pituitary gland?

A

Glucocorticoids

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183
Q

An adenoma in the pituitary may increase the ACTH secretion causing an increase in glucocorticoids and will not respond to the negative feedback

A
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184
Q

What is nodular hyperplasia

A

Masses in the adrenal cortex that doesnt cause disease

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185
Q

What is adrenal cortical hyperplasia?

A

Unlike nodular hyperplasia, this is diffuse thickening and always due to ACTH-secreting pituitary tumor

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186
Q

What are teh most ACTH responsive regions of the adrenal cortex?

A

Zona fasiculata and zona reticularis

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187
Q

What is the malignant tumor of the adrenal cortex?

A

Adrenal carcinoma

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188
Q

Where may the adrenal carcinoma invade?

A

Vena cava

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189
Q

What percent of ferrets will develop an adrenal-associated endocrinopathy?

A

70%

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190
Q

Spay/neuter of ferrets disrupt negative feedback of GnRH which increases luteinizing hormone, causing a stimulation of sex-steroid producing adrenal cells with overproduction

A
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191
Q

What hormones are increased in ferrets with adrenal disease?

A

GnRH and luteinizing hormone

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192
Q

What region of the adrenal gland is overproduced?

A

Hyperestrogenism

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193
Q

What are the clinical signs of ferret adrenal disease?

A

Alopecia
Enlarged vulva and mammary hyperplasia
Urinary obstruction, prostatic hyperplasia

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194
Q

What does paraganglioma mean?

A

Umbrella term for tumors derived from neural crest cells

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195
Q

Adrenal medulla is derived from neural crest cells which is different from the adrenal cortex!!!

A
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196
Q

What are tumors derived from teh adrenal medullary called?

A

Pheochromocytomas

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197
Q

What type of tumor is formed from alpha cells?

A

Glucagonoma

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198
Q

What type of tumor is formed from beta cells?

A

Insulinoma

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199
Q

What is the most common islet-origin tumor?

A

Insulinoma

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200
Q

Do insulinomas tend to be carcinomas?

A

Yes

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201
Q

What is caused by the increase in insulin produced by the insulinoma?

A

Hypoglycemia

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202
Q

What is a clinical sign of the insulinoma that causes hypoglycemia?

A

seizures

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203
Q

Ferrets will also get adenomas of the endocrine pancreas

A
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204
Q

What is likely a major cause of diabetes mellitus in dogs and cats?

A

pancreatic hypofunction

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205
Q

What causes the pancreatic hypofunction?

A

Secondary loss of beta cells by recurrent pancreatitis/chronic pancreatitis

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206
Q

What are 3 secondary lesions associated with diabetes mellitus?

A

Cachexia
Cataract
hepatic lipidosis

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207
Q

What is a common cause of islet degeneration in cats?

A

Islet amyloidosis

208
Q

What percent of cats have islet amyloidosis?

A

20%

209
Q

What percent of DM cats have islet amyloidosis?

A

60%

210
Q

What species is islet amyloidosis most common in?

A

Cats

211
Q

What is uniform, bilateral enlargement of thyroid gland called?

A

Goiter

212
Q

What may cause goiter?

A

Excess iodine
Iodine deficiency
Goitrogenic compound plants

213
Q

Who usually has goiter?

A

Fetuses/young food animals and horses that are born with it

214
Q

Why do the young have goiter?

A

Dam either is grazing on goitrogenic plants
Dam has iodine deficient diet
Iodine excess

215
Q

What plants are goitrogenic?

A

Brassicaceae family

216
Q

What does fetal goiter cause?

A

Abortion, stillbirth, prolonged gestation, dystocia, neonatal death

217
Q

Why would a dam have iodine excess?

A

Mares eating dry seaweed

218
Q

High iodine in fetal circulation interferes with thyroid hormone synthesis <T3. T4 deficiency -> goiter

A
219
Q

After correction of the iodine in goiter, what is it called?

A

Colloid goiter

220
Q

What are the 4 major players of calcium-regulating hormones?

A

PTH, calcitriol, calcitonin, FGF23

221
Q

What is another name for vitamin D3?

A

Cholecalciferol

222
Q

What is the active form of cholecalciferol?

A

calcitriol

223
Q

What is the role of vitamin D in the intestin?

A

Facilitates intestinal absorption of calcium (calcium binding protein)
Inhibits PTH synthesis and secretion

224
Q

When is PTH released?

A

When there is low calcium

225
Q

What is needed to activate vitamin D?

A

UV light (sheep more susceptible because fiber)

226
Q

What is rickets?

A

Defective vitamin D metabolism at sites of endochondral ossification

227
Q

What is osteomalacia?

A

Defective vitamin D metabolism at site of skeletal remodeling

228
Q

What causes rickets and osteomalacia?

A

Dietary deficiency in either vitamin D or phosphorus

229
Q

Where do the lesions most commonly occur for rickets?

A

Sites of rapid growth

230
Q

What are 3 reasons for primary hyperparathyroidism?

A

Parathyroid nodular hyperplasia, adenoma, carcinoma

231
Q

What are 2 reasons that may cause secondary hyperparathyroidism?

A

Chronic renal disease and dietary imbalances

232
Q

CKD causes hyperparathyroidism because the decreased GFR causes an increased blood phosphate. The increased phosphate causes an increased FGF23, decreased calcitriol production. Chief cell hyperplasia is a result and increases PTH production

A
233
Q

What is the primary cause of fibrous osteodystrophy?

A

Nutritional secondary hypercalcemia

234
Q

What is fibrous osteodystrophy?

A

Osteoclastic resorption of bone causing swelling, pliability, and fractured bone

235
Q

What are the 3 hypercalcemias secondary to neoplasia?

A

Humoral hypercalcemia of malignancy (HHM)
Metastasis to bone
Hematologic malignancies localized to bone

236
Q

What does PTHrP stand for?

A

Parathyroid hormone-related protein

237
Q

What does elevated PTHrP indicate?

A

Elevated values indicate neoplasia

238
Q

What 3 things is elevated PTHrP indicative of?

A

Apocrine gland adrenocarcinoma of the anal sac
T cell lymphoma
Multiple myeloma

239
Q

PTHrP has a very similar affect on the body as PTHrP

A
240
Q

What is the most common pituitary tumor in dogs?

A

Corticotrophs

241
Q

What is the most common pituitary tumor in cats?

A

Somatotrophs

242
Q

Can pituitary tumors be defined as carcinomas through histo alone?

A

No, only by metastasis

243
Q

What is the most common form of spontaneous hyperadrenocorticism?

A

Canine pituitary-dependent hyperadernocortisism (85%)

244
Q

HAC due to the pituitary gland will cause BILATERAL adrenal hyperplasia

A
245
Q

Are clinical signs the same if its adenoma vs adenocarcinoma?

A

YES!

246
Q

_______% of dogs have pituitary tumors not visible on CT or MRI

A

40-50%

247
Q

How is pituitary enlargement diagnosed on CT/MRI?

A

Pituitary height:brain ratio

248
Q

What is the threshold ratio consistent with enlargment?

A

> 0.31

249
Q

What is the mean age for feline pituitary-dependent HAC?

A

10years

250
Q

What is the most common tumor in feline HAC?

A

Adenomas

251
Q

How do cats present with HAC compared to dogs?

A

Sicker

252
Q

Feline patients presenting with HAC, what is it not uncommon to see as well?

A

Insulin-resistant diabetes mellitus

253
Q

What is seen on blood work for HAC??

A

Elevated ALP, ALT, hypercholesterolemia, azotemia, and low USG

Concurrent hyperglycemia, glycosuria

254
Q

What percent of adrenocarcinomas invade the renal vena cava?

A

20%

255
Q

What percent of adrenocortical carcinomas are metastatic?

A

50%

256
Q

What 2 spots do the adrenocortical carcinomas usually invade?

A

Liver
Lungs

257
Q

What can be a side effect and presenting complaint of invasion into the vena cava?

A

Hemoabdomen

258
Q

What is a go-to method for extent and invasion of a tumor?

A

CT

259
Q

What is the adrenal medullary tumor of the chromaffin cells?

A

Pheochromocytoma

260
Q

What do pheochromocytoma (chromaffin cells) secrete?

A

Catecholamines

261
Q

What is the metastatic rate of pheochromocytomas?

A

40%

262
Q

What are the common sites for metastasis of pheochromocytomas?

A

Liver, spleen, regional LN, and bone

263
Q

What is the vascular invasion rate of pheochromocytoma?

A

80%

264
Q

What is the best diagnostic approach for pheochromocytomas?

A

Abdominal ultrasound and CT
Plasma and urine catecholamine level
Histology: Chromogrenin A

265
Q

What are the 4 subgroups of thyroid tumors?

A

Follicular, compound, papillary, anaplastic

266
Q

What are the 2 most common subgroups of thyroid tumors in dogs?

A

Follicular and compound

267
Q

Are thyroid tumors usually benign or malignant?

A

Malignant

268
Q

What is an increasing risk factor for malignant thyroid tumor?

A

Bilateral involvement

269
Q

What is a syndrome related to the face that can be caused by thyroid tumors?

A

Horner’s syndrome

270
Q

What locations are the most likely area to metastasize to?

A

Lungs or retropharyngeal lymph nodes

271
Q

What are the top 2 diagnostic approaches for thyroid tumors?

A

CT
Ultrasound guided FNA

272
Q

What should you be aware with ultrasound guided FNA?

A

High vascular structure!

273
Q

What is an insulinoma?

A

Neoplasia of beta cells

274
Q

What does an insulinoma cause?

A

Upregulation of insulin

275
Q

What are the clinical signs of insulinomas?

A

Seizures
Collapse
Weakness

276
Q

What is serum test that will help confirm insulinoma?

A

Low blood glucose paired high insulin

277
Q

What is diabetes mellitus characterized by?

A

Hyperglycemia that results from defects in insulin secretion or insulin sensitivity in target tissues or both

278
Q

What is type I diabetes diabetes mellitus a result of?

A

Beta cell loss or destruction

279
Q

What is type II diabetes mellitus a result of?

A

Abnormal beta cell function

280
Q

What type of diabetes mellitus do dogs get?

A

Type I

281
Q

What type of diabetes mellitus do cats get?

A

Type II

282
Q

What is the threshold for cortical blood glucose in dogs?

A

180

283
Q

What is the threshold for cortical blood glucose in cats?

A

280

284
Q

***What are the 3 clinical signs of diabetes mellitus?

A

PU/PD
Polyphagia
Weight loss

285
Q

What is the pathophys of glucosuria in diabetes mellitus?

A

As blood glucose concentrations rise, there is too much glucose in the blood for the glomerular ultrafiltrate to resorb

286
Q

What causes the polyuria in diabetes patients?

A

Glycosuria creates an osmotic diuresis drawing urine into the tubules

287
Q

What causes polyphagia and weight loss?

A

The lack of insulin in diabetes causes little uptake of glucose into cells which is required to trigger satiety so body continuously wants to eat. Without peripheral tissue utilization, body loses a lot of glucose via urine

288
Q

What type of diabetes is unexpected weight loss more common?

A

Type I

289
Q

What is a common breed to get diabetes?

A

Miniature schnauzers

290
Q

In dogs, which sex is more likely to get DM?

A

Females

291
Q

What is a common presenting complain of DM?

A

Acute blindness

292
Q

In cats, which sex is more likely to get DM?

A

Neutered males

293
Q

What is an eye issue that may make you suspicious of diabetes?

A

Acute cataracts

293
Q

What is seen on CBC with DM?

A

No much

294
Q

What is seen on UA with DM?

A

Glucosuria
Proteinuria
Bacteriuria

295
Q

What is seen on chem with DM?

A

Hyperglycemia, Increased ALT and ALP, hypercholesterolemia

296
Q

Why do you see mildly increased liver values on chem?

A

The decreased insulin causes lipid mobilization which causes the liver to become inflamed and release some enzymes

297
Q

How do you document persistence of DM?

A

Fructosamine

298
Q

What is considered hypoglycemic?

A

BG less than 60

299
Q

What is Whipple’s triad of hypoglycemia?

A

Consistent clinical signs
Hypoglycemia
Response to treatment

300
Q

What do you expect to see in the chem of a dog with an insulinoma?

A

hypoglycemia

301
Q

What are the 4 main suspects of true insulin resistance

A

Bacterial infection
Organ failure
Pancreatitis
Concurrent endrocrinopathies (Cushing/Addisons)

302
Q

What is another iatrogenic cause of “insulin resistance”

A

Owners just not giving insulin correctly

303
Q

What is the Somogyi phenomenon?

A

Counter regulatory pattern of insulin induced hypoglycemia followed by hyperglycemia phase

304
Q

What causes insulin-induced hyperglycemia?

A

Too much insulin that stresses the animal and causes a counter-regulatory release of stress hormones

305
Q

What is acromegaly?

A

excessive release of GH

306
Q

What causes acromegaly?

A

Pituitary adenoma

307
Q

What does acromegaly cause?

A

Insulin resistance
IGF-1 release and bony and soft tissue overgrowth

308
Q

Are cats with acromegaly always diabetic?

A

YES!

309
Q

What is a clinical sign that is not seen in cats with acromegaly despite uncontrolled DM?

A

Weight loss

310
Q

What are the 2 diagnostics for acromegaly/

A

Measure of IGF-1
Brain imaging to confirm

311
Q

Will high IGF-1 always mean acromegaly?

A

No, there is some variation but will almost always mean that diabetes is not under control

312
Q

What will DM cause when screening for HAC?

A

False positives

313
Q

How do you test a HAC with DM?

A

Glucosuria, increased blood glucose, fructosamine

314
Q

What are the 3 ketone bodies?

A

Acetoacetate, BHB, acetone

315
Q

What causes sickness from DKA?

A

Ketones cause a high anion gap metabolic acidosis

316
Q

What are the common things seen on UA for DKA?

A

Ketones, uremic toxins, lactic acid, or salicylates

317
Q

How do you calculate anion gap?

A

(Na+K) - (Cl + HCO3)

318
Q

What must always be asked when a patient undergoes DKA?

A

Why did it

319
Q

Why do diabetics get DKA?

A

Lower insulin allows lipolysis, increasing availability of fatty acids.

320
Q

What are clinical signs of a dog in DKA?

A

Vomiting, dehydration, severe illness

321
Q

What things will be seen on diagnostics for DKA?

A

D - hyperglycemia / glycosuria
K - ketonemia / ketonurea
A - acidosis

322
Q

What specifically are you looking for in the urine of a DKA animal for diagnostics?

A

Acetone

323
Q

What comes from somatotropic cells in the anterior pituitary?

A

GH

324
Q

What contains receptors for GH to release IGF-1?

A

Liver

325
Q

GH has effects that can be characterized into which 2 categories?

A

Anabolic
Catabolic

326
Q

What does the catabolic affect do?

A

Increases insulin resistance

327
Q

What does the anabolic affect do?

A

IGF-1 leads to bone, fibrous, etc. growth

328
Q

What is the one difference in diabetes that acromegaly cats will present with?

A

Weight gain instead of loss

329
Q

Acromegaly cats can also present with some neurological signs

A
330
Q

So I know a previous answer to this was brain imaging and IGF but this is different… What is a one time measurement that can be used to diagnose acromegaly?

A

IGF-1

331
Q

Why does GH need to be measured at multiple time points with acromegaly?

A

There can be GH spikes

332
Q

What does MED stand for?

A

Multiple endocrine diseases

333
Q

What is the test of choice when you have multiple endocrinopathies present?

A

ACTH stim

334
Q

Which 2 diseasese have similar mechanisms?

A

Diabetes mellitus
Hypothyroidism

335
Q

What are essentially the same thing for large animals in terms of ketones?

A

Ketosis and pregnancy toxemia?W

336
Q

Who gets pregnancy toxemia and when?

A

Small ruminants before partuition

337
Q

Who gets ketosis and when?

A

Cattle after parturition

338
Q

What can be a consequence of chronic ketosis or pregnancy toxemia?

A

Hepatic lipidosis

339
Q

What is the transition period?

A

3w before and 3w after

340
Q

What are 3 things that change for ruminants in transition period?

A

Feed, social structure, daily routine

341
Q

When is peak milk production for a cow?

A

4-6 weeks

342
Q

When is peak feed consumption?

A

7-8 weeks

343
Q

“Lake gestation fetus steals space from rumen”

A
344
Q

What happens when there is a negative energy balance during transition period?

A

Mobilize NEFAs

345
Q

What is the site of gluconeogenesis and ketone production?

A

Liver

346
Q

What is the primary NEFA?

A

BHB

347
Q

What is primary ketosis?

A

Lactation energy demands are too high

348
Q

What is secondary ketosis?

A

Decreased feed consumption

349
Q

Which ketosis type has a higher risk for hepatic liposis?

A

Type II

350
Q

What is type I ketosis?

A

Peak lactation / high production cow

351
Q

What is type II ketosis?

A

Early lactation, overweight cow in dry period

352
Q

What do NEFAs and BHB increase activation of?

A

Pro-inflammatory (NF-KB)

353
Q

When is peak incidence of hyperketonemia?

A

5 days in milk

354
Q

What is the gold standard for determining ketosis?

A

Blood BHB

355
Q

What is the clinic threshold for ketosis?

A

> 3

356
Q

What are the 3 tests you can run to measure ketosis?

A

Urine
Blood
Milk

357
Q

What is the median time of resolution of ketosis?

A

5 days

358
Q

What is the prognosis of pregnancy toxemia?

A

Poor

359
Q

pregnancy toxemia can occur in beef cows

A
360
Q

When does pregnancy toxemia occur?

A

Final 4-6 weeks of pregnancy

361
Q

Why dont small ruminants eat more in late gestation?

A

Increased uterus makes it physically unable to consume more

362
Q

What inhibits the normal circulation of the kreb cycle?

A

Oxaloacetate

363
Q

What is a common clinical department of pregnancy toxemia?

A

Nervous system

364
Q

What is gold standard diagnostic for pregnancy toxemia?

A

BHB

365
Q

What is clinical pregnancy toxemia BHB levels?

A

> 2.6

366
Q

What are the 2 scenarios in which you may see a sudden drop in BHB?

A

Treatment is working
Lamb/kid dies

367
Q

What is a large contributing factor to hepatic lipidosis?

A

Overconditioned in dry period

368
Q

All high producing dairy cows have some degree of increased fat in liver

A
369
Q

What is mortality of hepatic lipidosis/

A

> 25%

370
Q

What is the gold standard to diagnose hepatic lipidosis?

A

Liver biopsy

371
Q

What hormones do camelids produce a lot more of than other domestic species?

A

T3 and T4

372
Q

Is normal blood glucose higher in camelids than ruminants?

A

YES! Like 2x higher

373
Q

Camelids have a _______ insulin production?

A

Low

374
Q

Camelids are very sensitive to insuline diseases becuase of their low production

A
375
Q

NEFAs, BHB, and triglycerides should all be ________ in fed state?

A

LOW

376
Q

With hyperlipidemia in camelids, unlike cattle, what level of BHBs will you see in camelids?

A

Low

377
Q

Are clinical changes severe or mild in camelids with hyperlipidemia?

A

More severe

378
Q

What is a large contributing factor to ketosis in camelids?

A

Stress

379
Q

Since camelids release very low insulin, stress will cause cortisol release causing increased levels of gluconeogenesis and thus glucose resulting in hyperglycemia

A
380
Q

Camelids are known as the what of large animals?

A

Cats

381
Q

*** What 5 effects do NEFAs have?

A

Pro-inflammatory
Cytotoxic
Inhibit hepatic glycogen storage
Inhibit glucose uptake
Increase insulin resistance

382
Q

What 2 things may cause hepatic lipidosis in camelids?

A

Hypoglycemia
Hyperglycemia
“Feast or famine”

383
Q

What level of BHBs are indicative of hepatic lipidosis in camelids/

A

> 2.5

384
Q

What is the blood glucose renal threshold?

A

> 200

385
Q

What is the main clinical sign of hyperglycemia in camelids?

A

PU/PD

386
Q

Is diabetes mellitus rare in camelids?

A

YES

387
Q

What are the clinical signs of diabetes mellitus in camels?

A

PU/PD
Ocular changes
Ulcerative foot lesions

388
Q

How much total calcium is lost in 24 hours during partuition?

A

46-48g

389
Q

What 3 things contribute to the loss of calcium during partuition?

A

Maintenance
Fetal skeleton
Milk/colostrum

390
Q

What are 4 risk factors for milk fever?

A

Older cows
Periparturient diseases
Breed
Alkalosis

391
Q

What are the 3 diet risk factors for milk fever?

A

High cations, low magnesium, high phosphorus

392
Q

What does a high cation diet cause?

A

Alkalinizing effect

393
Q

What is a non-lactating cause of hypocalcemia?

A

Oxalate-containing plants

394
Q

/What is stage I hypocalcemia?

A

Tremors, head open, tongue extended

395
Q

What is stage II hypocalcemia/

A

Sternal recumbancy, still able to stand, hypothermia, S curve neck

396
Q

What is stage III hypocalcemia?

A

Flaccid muscles, lateral recumbancy, bloat

397
Q

Dogs and cows act differnetly with calcium… Dogs: lower ionized calcium causes acetylcholine release causing inctact muscles resulting in hyperthermia and tetany. Cows: lower ionized calcium causes acetylcholine release inhibiting muscles and causing hypothermia and flaccid paralysis.

A
398
Q

What is the key role in immune cell signaling and activation?

A

Calcium

399
Q

What are 3 risk factors of hypocalcemia in small ruminants?

A

Older
Multiple fetuses
High milk production

400
Q

What 2 things cause the release of PTH?

A

Low Ca and Low Mg

401
Q

What does PTH do to phosphorus?

A

Decreases levels

402
Q

What are 4 risk factors for low vitamin D?

A

Fall born
Dark coat
Heavy fleece
Rapid growth

403
Q

Why does hyperphosphatemia occur a lot?

A

Poor diets high in phosphorus low in calcium

404
Q

What does hyperphosphatemia do to the parathyroid gland?

A

hyperplasia

405
Q

What is hypocalcemia of pigs called?

A

Eclampsia

406
Q

How much is too much calcium to give to a hypocalcemic cow?

A

1-2 bottles

407
Q

What is almost always associated with hypervitaminosis?

A

Hypercalcemia and hyperphosphatemia

408
Q

What is the difference between hyperlipidemia and hyperlipemia

A

Hyperlipemia is a disease state

409
Q

What is hyperlipemia?

A

Hypertriglyceridemia in horses

410
Q

What is the level typically resulting in hyperlipemia?

A

> 500

411
Q

What are 3 risk factors of hyperlipemia?

A

Late gestation
Lactation
Heavy work

412
Q

Hyperlipemia is increased triglyceridemia that results in disease most commonly caused by increased metabolic demands and mobilization of lipids

A
413
Q

What are predisposed breeds to hyperlipemia?

A

Small, stocky thangs OR overweight horses brought into negative energy balance

414
Q

What is hormone sensitive lipase sensitive to?

A

Insulin

415
Q

What are the 3 main tissues responsive to insulin?

A

Muscle
Liver
Fat

416
Q

What is a nearly pathogneumonic lesion of hyperlipemia?

A

Plaque of ventral edema

417
Q

***Assume hyperlipemia is present in any ill equid of a predisposed species and test for it in others

A
418
Q

What may you see to diagnose hyperlipemia in serum?

A

Increased triglycerides in serum

419
Q

What special stains should be done to diagnose hepatic lipidosis?

A

Oil Red O
PAS

420
Q

What effect does lipid have on total protein?

A

Lipid causes an increased tp on refractometer

421
Q

Hyperlipidemia causes errors in clinical chemistry assessments via several mechanisms (pseudohyponatremia, pseudohypokalemia, pseudohypochloridemia)

A
422
Q

What is the complete inability to sweat when physiologically appropriate?

A

Anhidrosis

423
Q

What is the insufficient sweat under same conditions?

A

Hypohidrosis

424
Q

What is a clinical sign of anhidrosis?

A

Tachycardiac
Exercise intolerance
Hyperthermia

425
Q

What is the diagnosis for anhidrosis?

A

Intradermal sweat test

426
Q

Is hypocalcemia or hypercalcemia more common?

A

Hypercalcemia

427
Q

____________ hypoparathyroidism and ____________ hyperparathyroidism cause hypocalcemia

A

Primary, secondary

428
Q

What are the 5 top differential for hypoparathyroidisim?

A

Hypoparathyroidism
Eclampsia
Malabsorption
Pancreatitis
Nutritional hyperparathyroidism

429
Q

What level should PTH be when total calcium/ionized calcium is low?

A

PTH should be above reference interval

430
Q

What is the most common reason for primary hypoparathyroidism?

A

Immune-mediated

431
Q

What are classic signs of hypoPTH?

A

Facial rubbing
Tremors
Seizures

432
Q

If calcium is low, which direction is phosphorus usually?

A

high

433
Q

What 2 tests do you need to make the definitive diagnostic for hypoPTH?

A

Paired PTH and ionized calcium

434
Q

What is eclampsia?

A

Puerperal tetany

435
Q

What increases likelihood of a dog getting eclampsia

A

Small dogs with large litters (first 3 weeks of lactation)

436
Q

What are 2 causes of secondary hyperparathyroidism?

A

Renal and nutritional

437
Q

Can you differentiate secondayr and primary hypocalcemia on a paired inionzed and PTH panel alone?

A

NO!

438
Q

Chronic kidney disease may wash out all of the Calcium in the body causing a cycle of resorption of bone leading to demineralization of the body

A
439
Q

With low calcium, what other values do you see?

A

High phosphorus and low vitamin D

440
Q

What significant values do you see in CKD?

A

Low vitamin D

441
Q

What nutrients will cause secondary hyperparathyroidism?

A

Diets low in Ca
Diets low in Vit D
Diets high in P

442
Q

What is the ration of Ca:P that is bad?

A

Ca:P < 1

443
Q

What is the orthopedic sign seen with nutritional hyperPTH?

A

Fibrous osteodystrophy

444
Q

What are the clinical signs of nutritional hypoPTH?

A

Orthopedic issues (lameness, limb deformities)

445
Q

Who do you see nutritional hypoPTH in the most?

A

Young growing animals

446
Q

Can serum Ca and P be normla in a nutritional hypoPTH animal?

A

YES!!

447
Q

What is another name for PPID?

A

Equine cushings

448
Q

PPID’s pathophysiology is similar to what human disease?

A

Parkinson’s

449
Q

What part of the pituitary do humans not really have?

A

Pars intermedia

450
Q

Where is the lesion causing PPID?

A

Pars intermedia

451
Q

What does PPID stand for?

A

Pituitary pars intermedia dysfunction

452
Q

Where is ACTH made?

A

Pars distalis

453
Q

When is ACTH secreted normally?

A

In the fall for a winter coat

454
Q

What occurs with PPID?

A

The ACTH signals are constantly sent

455
Q

What are the retained hairs from PPID called?

A

Guard hairs

456
Q

What are 6 main clinical signs of PPID?

A

Hypertrichosis
Weight loss/muscle loss
Laminitis
Secondary infection (endoparasites)
PU/PD
Hyperhidrosis

457
Q

What clinical sign is associated with the weight loss?

A

Dropped abdomen

458
Q

Is PPID primarily cortisol driven?

A

No

459
Q

Some other clinical signs to think about: Regional adiposity (supraorbital fossae, delayed wound healing, seizure / neuro issues)

A
460
Q

What is the only risk factor for PPID?

A

Age

461
Q

What is considered (but not that accurate) gold standard for PPID?

A

Histopathology of Pars intermedia

462
Q

What is the recommendation for diagnosing PPID?

A

Use multiple diagnostic tests

463
Q

What are the 2 current tests to be used for diagnosing PPID?

A

endogenous ACTH
TRH - Stimulation test

464
Q

When is the e-ACTH test most sensitive?

A

Fall!

465
Q

When is teh TRH stim test most senestive?

A

Fall!

466
Q

How do you do the TRH stim test?

A

Get 1mL baseline blood sample, give TRH, measure ATCH at 10 min and 30 min

467
Q

What do owners usually report as laminitis associated with green pasture?

A

Seasonal lameness

468
Q

Why does green pasture cause laminitis/

A

Acute increase in carbs triggering inflammatory cytokines

469
Q

What are the 3 risk factors of EMS?

A

Obesity
Insulin dysregulation
History or current lameness

470
Q

Where is the regional fat for EMS usually found?

A

Neck and tail head

471
Q

What is laminitis?

A

Disease/disruption of the digital lamellae

472
Q

What are cases with rotation or distal displacement of the coffin bone?

A

Founder

473
Q

***Who is predisposed to EMS?

A

Ponies
Donkeys
Mules
(Gaited Horses)
American Saddlebreds
Tennessee Walking Horses
Morgans
Paso Finos
Arabians

474
Q

What are the 3 current tests for EMS?

A

Basal insulin and glucose concentration
Oral sugar test
IV insulin tolerance test

475
Q

You need to do all 3 tests for diagnosis. If just one tests positive, EMS is likely

A
476
Q

Most hypocalcemic disorders are ______

A

acute

477
Q

Most hypercalcemic disorders are ______

A

chronic

478
Q

What does sepsis do to calcium?

A

Hypocalcemic

479
Q

What is the cause of primary hypothyroidism in horses?

A

Idiological

480
Q

What kind of calcium do striated muscles need?

A

Intracellular Ca

481
Q

What kind of calcium do neurons and smooth muscle need?

A

Extracellular Ca

482
Q

What are types of secondary hypoparathyroidism?

A

Sepsis, low magnesium

483
Q

What is a clinical sign of hypocalcemia associated with breathing?

A

Synchronous diaphragmatic flutter

484
Q

What causes impaired thyroid gland dysfunction?

A

Cytokines

485
Q

Why does diarrhea cause hypocalcemia?

A

Lost in intestines

486
Q

Acidosis or alkalosis leads to signs of hypocalcemia?

A

Alkalosis

487
Q

Acidosis or alkalosis falsely elevated Ca?

A

Acidosis

488
Q

Why do horses with anterior enteritis get hypocalcemic?

A

Horses lose Cl- and replaced by HCO3 causing alkalosis -> hypocalcemia

489
Q

What is a C-cell adenoma?

A

Adenoma of the thyroid gland

490
Q

Non-functional C-cell adenomas are majority compared to functional c-cell adenomas

A
491
Q

What do functional C-cell adenomas secrete?

A

Calcitonin

492
Q

What are 4 causes of hypercalcemic disorders in horses?

A

Hyperparathyroidism
Chronic renal failure
Vitamin D intoxication
Cancer - HHM

493
Q

What are the 3 reasons that hypercalcemia causes PU/PD

A

High Ca blocks electrolyte and water reabsorption, inducing diuresis

High Ca blocks the actions of antidiuretic hormone (ADH)

High Ca acts like Lasix blocking electrolyte reabsorption

494
Q

What are 2 causes of secondary hyperparathyroidism?

A

Renal disease
Nutritional

495
Q

What are 3 reasons a horse can have hypervitaminosis D

A

Iatrogenic
toxic plants
Rodenticides

496
Q

Increased vitamin D equals….?

A

Increased Ca, increased P

497
Q

How can you tell if a horse has vitamin D toxicity?

A

Both high Ca and P

498
Q

What is hypercalcemia of malignancy?

A

HHM

499
Q

What are the laboratory findigns of HHM?

A

Hypercalcemia, Hypophosphatemia, high PTHrP, low PTH

500
Q

Chronic renal failure can cause hypercalcemia

A
501
Q

What cause hypercalcemia in chronic renal failure?

A

Less renal Ca excretion

502
Q

What is the main cause (most common) of hypercalcemia in horses?

A

Chronic renal failure

503
Q

Hypocalcemia and hypomagnesemia are frequent in critically ill horses

A
504
Q

What panel do you run for PTH and calcium?

A

Malignancy panel

505
Q

What is the average age of dogs with primary hyperparathyroidism?

A

10 years old

506
Q

*****Why are hypercalcemic animals PuPD?

A

Calcium interferes with antidiuretic hormone (ADH) hypercalcemia also causes nephrogenic diabetes inspidus (NDI)

507
Q

What should you think if you see mild to moderate hypercalcemia in a young cat?

A

Idiopathic hypercalcemia

508
Q

What are the 3 causes of hypercalcemia with cancer?

A

Humoral hypercalcemia with cancer (PTHrP)
Cancer in the bone marrow
Tumor metastasis to bone

509
Q

Which disases are hte most common causes of hypercalcemia in cats?

A

Neoplasia, renal disease, hyperparathyroidism, Addison’s disease

510
Q

Which diseases are the most common causes of hypercalcemia in dogs?

A

Neoplasia, renal disease, urolithiasis

511
Q

What are 3 humoral hypercalcemia of malignancy?

A

Lymphoma
Anal sac adenocarcinoma
Squamous cell carcinoma

512
Q

What are 2 cancers of bone marrow?

A

Lymphoma
Multiple myeloma

513
Q

What are 2 solid tumors of the bone?

A

Mammary carcinomas
Squamous cell carcinoma

514
Q

Does osteosarcoma induce hypercalcemia?

A

NO!!!

515
Q
A

Diseases and Diagnosis (23 decks)

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