endocrin Flashcards
A patient presents with a history of weakness, collapse and seizures What is the top endocrine differencial
hypoglycemia
Hypoglycemia with concurrent leukopenia is suggested of what top differential
sepsis
when monitoring urine with keto/glucose sticks what levels are considered normal in diabetic animal
Ketones: negative or less than 2 Glucose 250-1000, occasional negatives with no clinical signs OK
inappropriate insulin overproduction does what to blood glucose levels
decreases blood glucose- hypoglycemia
Hypoglycemia with concurrent hypercholesterolemia, decreased BUN and cholesterol is suggested of what top differential
Liver atrophy or failure
What is the insulin counterregulatory action of glucagon
catabolic- stimulates the liver to produce more glucose. Overall increases blood glucose
Where is glucose made
Liver and kidney
What are th CATS of hypoglycemia
C- convolsions A- arrhythmeia T- tetany S- Spasms and Stridor
What is the pancreatic response to decreased blood glucose
The pancreas releases glucagon, and stops releasing insulin
T/F Vomiting, Pu/Pd can be symptoms of hypoglycemia
T- neurologic signs would be expected first
An owner checks their dog’s glucose and finds it is above 300. They want to know if you’ve calculated the wrong dose. Do you advise to give another dose of insulin?
No, you cannot trust a high spot blood glucose. Advise to retest.
What is somogyi
a phenomone of insulin overdose. A rebound hyperglycemia caused by overstimulation of the counterregulatory hormones (cortisol, glycogen, catecholamines and growth Hormone)
An owner’s pet was just diagnosed as being diabetic. They had a cousin that was diabetic who needed a leg amputated and they are concerned about their pet. What do you advise treatment,
Develope of neuropathy, retinopathy and vasculopathy not typically seen in animals
what are the layers of the adrenal gland
in the cortex- glomerulus controls minerals fasiculata controls glucose reticulart controls sex hormones and glucose the medulla controls catecholamines (epi, norepi)
What are the counterregulatory hormones released in the presence of hypoglycemia
the anti-hypoglycemia hormones are cortisol, Growth Hormone, catecholamines and glucagon
What is the normal pancreatic response to elevated blood glucose
The pancreas secretes Insulin
What is the insulin counterregulatory action of catecholamines
stimulates lipase to release fatty acids stimulates glycogenolysis (potently!) Overall it increases blood glucose
What are the reasons of Hypercalcemia
Hogs in Yard H- hyperparathyroidism O- osteolysis G- granulomatous disease S- spurious I- iatrogenic, idiopathic(cats) N- neoplasia A- addison’s, acidemia Y- youth R- renal disease D- vitamin D toxicosis
An owner calls the clinic and describes their cat with signs of shaking, collapse, seizures and a history of vomiting. Should you advise to give it insulin?
NO INSULIN give sugar, and bring to hospital
Hypoglycemia with concurrent hypocholesterolemia is suggested of what 2 top differentials
Hepatic Disease, Addison’s disease
What is the insulin counterregulatory action of growth hormone
decreases cellular utilization of glucose and increases fat utilization insead. Overall changes fuel source for most cells
What blood glucose levels define hypoglycemia, and at what level are clinical signs seen
hypoglycemia defined by blood glucose levels of less than 70-80. Clinical signs at less than 50
Hypoglycemia with concurent high insulin indicates what disease
Hypoglycemia with normal or high insulin is diagnostic of INSULINOMA. Hypoglycemia should result in low insulin levels!!!
What is the treatment for hypoglycemic crisis
50% dextrose diluted 1:1 (25%) with 0.9% NaCl - 1ml/kg
What is the insulin counterregulatory action of glucosteroids
decreases cellular utilization of glucose and increases fat utilization insead. Overall changes fuel source for most cells
hypoadrenocorticism is also called
Adisons
Adisons disease is also known as
hypoadrenocorticism
cushings is also know as
hyperadrenocorticism
the disease associated with tumors of the adrenal gland medula is called
pheochromocytoma
T/F Fructosamine will be low in cases of insulin overdose
F, it can be low or high
A sick patient with hypoglycemia with concurrent hypercholesterolemia and normal leukocyte count is suggested of what top differential
Addisons- A sick animal should have a stress leukogram, but with Addison’s, no cortisol to stimulate the normal responce
hyperadtenocorticism is aksi known as
cushings
What are the insulin counterregulatory hormones
catecholamines, glucocorticoids, growth hormones, glucagon
T/F Development of vasculopathy and proteinuria is rarely seen in diabetic animals
False vasculopathy isn’t usually seen in animals, but proteinuria is and can be substantial!
What is the benefit of treating hypoglycemic seizures with Keppra instead of diazepam
Keppra does not require liver, while diazepam does.
what clinical signs would cause you to susspect Adisons disease
Hypoglycemia with concurrent hypocholesterolemia
