Endocrine

Question 1

dPituitary apaplexy is associated with presence of what in dogs?

Answer 1

Intrasellar or suprasellar pituitary mass with acute intratumoral haemorrhage

Question 2

Dogs with severe muscle stiffness and hyperadrenocorticism typically have which form of HAC? What response is seen to trilostane or mitotane?

Answer 2

PDH, no response to treatment

Question 3

Rat terriers with congenital hypothyroidism have regional CNS hypomyelination due to mutation in which gene?

Answer 3

Thyroid peroxidase gene

Question 4

Levels of which pituitary hormone can correlate with clinical signs of nausea?

Answer 4

AVP

Question 5

Nesidioblastosis refers to what?

Answer 5

Beta cell hypertrophy or hyperplasia - excess glucose utilisation due to hyperinsulinism

Question 6

automated chemistry analysers assessing glucose by the hexokinase assay rely on stectrophotomeetric quantification of which analyte?

Answer 6

NADH - is directly correlated to amount of glucose in a sample (glucose-6-phosphate which is formed from glucose + ATP by hexokinase is oxidised by NAD in reaction catalysed by glucose-6-phosphate dehydrogenase to produce NADH)

Question 7

why do human portable BG monitors have a tendency to underestimate dog/ cat BG conc?

Answer 7

Meters use formula that calculates glucose concentration as if derived from the plasma and not from capillary whole blood to facilitate comparisons with lab measurements, however whereas human RBCs have 50% glucose, dogs = 12.5% and cats 7%, therefore methodology tends to underestimate BG in veterinary species (alpha trek is plasma calibrated to account for differences in glucose distribution in whole blood in dogs and cats)

Question 8

what are the functions of the cells of the endocrine pancreas islets of langerhans? How do levels of the different hormones secreted impact each other?

Answer 8

alpha cells - glucagon, beta cells (60% total islet cells) - insulin , amylin, delta cells- somatostatin, PP cells- pancreatic polypeptide
Insulin inhibits glucagon secretion, amylin inhibits insulin secretion, somatostatin inhibits insulin and glucagon secretion

Question 9

Measurement of what would theoretically aid tracking of endogenous insulin levels?

Answer 9

C peptide

Question 10

What effects does hypothyroidism have on adipokines?

Answer 10

lower visfatin and betatrophi

Question 11

which ultra-long acting insulin shows promise for feline diabetes?

Answer 11

AKS-267c

Question 12

Which reneal biomarker may decrease after RAI treatment in hyperthyroid cats despite a decrease in GFR?

Answer 12

SDMA

Question 13

Which cohort of addisonian dogs may require higher DOCP doses?

Answer 13

young and growing

Question 14

In cats with hypoglycaemia, FSL may overestimate blood glucose below what cut off?

Answer 14

<60mg/dL or 3.3 mmol/L (FSL under-estimates BG for less severe hypoglycaemia)

Question 15

Which test differentiates thyroid dysmorphrogenesis from dyshormonogenesis in cats with congenital hypothyroidism?

Answer 15

high uptake of technetium perchlorate but abnormally low uptake of radioiodine

Question 16

Which hormone decreases after successful treatment of hypertriglyceridemia with diet in MS?

Answer 16

insulin

Question 17

What calcium disturbances occur in dogs with hyperadrenocorticism?

Answer 17

hyperphosphataemia, increased calciuresis, lower FGF-23 and 25OHD.

Question 18

what proportion of dogs with hyperadrenocorticism have systemic hypertension?

Answer 18

71%

Question 19

What is the median time to normoglycemia in cats with DKA treated with lispro insulin?

Answer 19

7 hours

Question 20

What is the sensitivity and specificity of lymphocyte count >1.75x10^9/L for detection of glucocorticoid deficient hypoadrenocorticism?

Answer 20

96.6% sensitive, 60.3% specific

Question 21

Which endocrinopathy is significantly associated with CKD in cats?

Answer 21

Diabetes

Question 22

What is the median effective DOCP dose for cats with primary hypoadrenocorticism?

Answer 22

2.3mg/kg (advise starting cats on 2.2mg/kg)

Question 23

what is a common post-operative complication of thyroidectomy for thyroid tumours in dogs?

Answer 23

hypothyroidism (64% cases)

Question 24

what features of insulinoma are associated with poorer survival?

Answer 24

presence of metastasis and medical rather than surgical management

Question 25

which biochemical parameters can indicate control in cushingoid dogs

Answer 25

haptoglobin, ALT and GGT

Question 26

Which antifungal treatment may result in iatrogenic hypoadrenocorticism?

Answer 26

ketoconazole

Question 27

Which ECG features are commonly seen in hypothyroid dogs?

Answer 27

decreased p and r wave amplitude

Question 28

what factors impact survival in dogs with pituitary masses treated with radiotherapy?

Answer 28

definitive intent RT and higher Gy dose

Question 29

muscle mass improves in what percetage of cats after successful RAI treatment of hyperthyroidism?

Answer 29

88% had improvement in epaxial mm height

Question 30

what is the median time to discontinuation of insulin in cats entering remission after hypophysectomy for HST/

Answer 30

9 days (range 2-120)

Question 31

What effect may concurrent administration of desmopressin have to dogs receiving prednisolone?

Answer 31

decreases in water intake and increases in USG (also hypona - desmopressin related?)

Question 32

in the absence of ability to measure ionised calcium, what is the specificity of predicted ionised calcium for hypercalcaemia?

Answer 32

81.60%

Question 33

urinary excretion of which neurohormone is higher in dogs with PDH than SARDS?

Answer 33

urine 6-sulatoxymelatonin (MTS6):creatinine ratio

Question 34

Which formulation of trilostane is associated with marked underdosing?

Answer 34

trilostane packets (Korea)

Question 35

which biochemical stress marker is altered in cats with chronic literbox issues?

Answer 35

hair and nail cortisol

Question 36

which hemostatic markers are altered in hyperthyroid cats?

Answer 36

AT, fibrinogen and vWF antigen

Question 37

what is 3 year survival of cats having hypophysectomy?

Answer 37

56% (Utrecht paper)

Question 38

which medication may be of use as part of a suppression test for feline hyperaldosteronism?

Answer 38

telmisartan

Question 39

which calcium metabolism marker is abnormal in dogs with histoplasma, and what biochemical markers does it correlate with?

Answer 39

25OHD is low, negatively correlates with globulin and CRP and positively with albumin.

Question 40

what structural advantage does lispro have over regular insulin for management of DKA via an IM/SQ protocol?

Answer 40

synthetic rapid acting insulin analog (where as regular insulin = human regular insulin) - structure differs slightly via AA replacement, hindering hexamerization and speeding absorption and metabolism (where as regular insulin is solution of zinc insulin hexers where absorption requires dissociation following IM/SQ injection)

Question 41

which four counter-regulatory hormones are secreted in response to hypoglycaemia?

Answer 41

glucagon, GH, glucocorticoids and catecholamines (glucagon and catecholamines important in short-term response)

Question 42

Cats achieving diabetic remission during treatment with exenatide-ER, glargine and a low carbohydrate diet had what feature on blood glucose curve analysis?

Answer 42

Lower glycemic variability compared to those without remission at week 6

Question 43

What variable remained unchanged in cats in diabetic remission receiving exenatide-ER compared to placebo?

Answer 43

Hemoglobin A1C

Question 44

What are risk factors for subclinical bacterirua in cats?

Answer 44

female sex, dilute USG (<1.035), pyuria, microscopic bacteriuria

Question 45

Occurrence of what might trigger development of clinical signs of hypoadrenocorticism in dogs treated with trilostane?

Answer 45

concurrent disease

Question 46

what percentage of dogs develop DM after surgical management insulinoma?

Answer 46

10% (in ettinger- JVIM paper 9%)

Question 47

what factors are associated with decreased survival in patients undergoing insulinoma surgery?

Answer 47

increased stage of disease, post-operative hypoglycemia

Question 48

what proportion of dogs with ionised hypercalcemia have normal total calcium?

Answer 48

one third

Question 49

What are the three most common causes of feline hypercalcaemia

Answer 49

AKI, malignancy and idiopathic

Question 50

What is the best method of monitoring clinical response to trilostane?

Answer 50

clinical signs

Question 51

Effusions from dogs with pancreatitis may be high in what?

Answer 51

triglycerides

Question 52

What is the PPV of Tca >2.99mmol/l for ionised hypercalceamia?

Answer 52

93%

Question 53

what factors may indicate over-treatment in dogs with Addisons receiving 2.2mg/kg of DOCP?

Answer 53

lower USG and suppression of renin (renin overly suppressed in 80.8% of dogs receiving the 2.2mg/kg dose)

Question 54

Which corticosteroids have been shown to be concurrently elevated in cats with markedly elevated aldosterone compared with cats with normal aldosterone?

Answer 54

progesterone and corticosterone

Question 55

what is the most common electrolyte abnormality after hypophysectomy in dogs?

Answer 55

hypernatraemia

Question 56

what are risk factors for development permanent DI in dogs after hypophysectomy?

Answer 56

longer surgery and larger mass

Question 57

What factors may help predict occurrence of both iatrogenic hypothyroidism and persistent hyperthyroidism after RAI treatment?

Answer 57

Iatrogenic hypothyroidism- older cats, female, detectable TSH , bilateral thyroid nodules, homogenous , bilateral distribution of Tc uptake Persistently hyperthyroid- younger cats, higher severity score, lower 131-I uptake

Question 58

what is the prevalence of hypoadrenocorticism in dogs with chronic GI signs?

Answer 58

4%

Question 59

what is the prevalence of hypertension in dogs with Cushings?

Answer 59

82%

Question 60

What histo findings make up the Utrecht score in canine adrenocortical tumours?

Answer 60

Ki67 proliferation index (%), +4 if >/33% cells have clear/ vacuolated cytoplasm , +3 if necrosis present Survival time best if score <6 vs worse if >/= 6 to <11 and worst if >/= 11

Question 61

which factors are associated with increased likelihood of ionised hyperCa in addisonian dogs?

Answer 61

hypokalaemia, young age

Question 62

What proportion of dogs with DM have a positive culture, and what proportion of those have lower urinary tract signs?

Answer 62

14% positive culture, 27% of positive culture have LTUS

Question 63

what sensitivity and specificity have been reported for an 8 hour LDDST cut off of 36 nmol/L

Answer 63

85.2% sensitivity and 100% specificity

Question 64

In diabetic cats with adrenal tumors suggestive of hyperaldosteronism, consideration should be given to production of which other steroid?

Answer 64

progesterone

Question 65

What is a severe adverse effect of SGLT2 treatment of diabetic cats that can be fatal?

Answer 65

eDKA

Question 66

What is the death rate of adrenal FNA?

Answer 66

1%

Question 67

what factor at diagnosis is not helpful to predict presence of metastasis in dogs with insulinoma?

Answer 67

Insulin

Question 68

what effect does weight gain and loss have on IGF-1 in cats?

Answer 68

none

Question 69

Which thyroid markers may predict survival in cats with non-thyroidal illness?

Answer 69

T4 and TSH

Question 70

Which LDDST pattern had highest positive predictive value for diagnosis of HAC?

Answer 70

Lack of suppression pattern (94%) (vs partial suppression pattern 68%) and escape or inverse pattern (both 37%)

Question 71

What marker of GFR may not be elevated above the RI in untreated dogs with hypothyroidism?

Answer 71

SDMA

Question 72

which method of RAI administration (oral vs SC) is associated with greater thyroid update?

Answer 72

no difference

Question 73

what factors are associated with higher thyroid-cancer related death in dogs undergoing thyroidectomy?

Answer 73

Presence of metastasis, non follicular carcinomas

Question 74

T4 at which level at discharge post RAI predicts treatment failure?

Answer 74

150 nmol/L

Question 75

which once weekly insulin treatment may be of use for canine diabetes

Answer 75

AKS-218d

Question 76

What is the sensitivity and specificity of a UCCR <1.4 for diagnosis hypoadrenocorticism?

Answer 76

100% sensitive, 97.3% specific

Question 77

USG below which threshold is associated with increased likelihood of developing azotaemia in hyperthyroid cats treated with RAI?

Answer 77

<1.035

Question 78

which stimulation test may be of use to differentiate PDH from ADH?

Answer 78

CRH stim

Question 79

what proportion of outpatient diabetic cats with continuous glucose monitoring systems have sensor displacement or failure?

Answer 79

80%

Question 80

What drugs may impact thyroid hormone testing results in dogs?

Answer 80

glucocorticoids, phenobarbital, NSAIDs (eg, aspirin), sulfonamides, inhalant anesthetics, clomipramine, toceranib, amiodarone, and trilostane

Question 81

How may acute pancreatiits affect vitamin D balance?

Answer 81

Acute pancreatitis associated with lower levels of 25(OH)D and vitamin D receptors

Question 82

which stages of the oestrus cycle are associated with higher concentrations of total thyroxine in GSD?

Answer 82

oestrus and diestrus

Question 83

In a dog with suspected non-thyroidal illness, when will assessment of TT4, fT4 by ED and TSH help or hinder your interpretation of thyroid function?

Answer 83

TT4- wait 2-4 weeks after recovery from NTI to check (will be reduced during illness) fT4 - could check during illness (less likely to be impacted, in JVIM paper 0% reduced at discharge/2/4 wks and only 16% reduced on admission) TSH - may go up 2 weeks (4%) and 4 weeks (12%) on recovery from NTI, 0% cases had increases at admit/ discharge time

Question 84

Mild increases in which gastrointestinal hormone may be seen in dogs with primary hyperparathyroidism?

Answer 84

gastrin

Question 85

which anxiolytic medication may dampen the adrenocortical response to stimulation in healthy dogs?

Answer 85

trazodone

Question 86

what may be a risk factor for acute adrenal necrosis (other htan trilostane/ mitotane administration)?

Answer 86

recent anaesthesia

Question 87

what is the median time to recovery of the HPA after administration of intermediate-acting glucocorticoids?

Answer 87

3 days

Question 88

what percentage of dogs with documented hyperglycaemia on a random occasion go on to develop the need for exogenous insulin treatment?

Answer 88

3.5%

Question 89

what possibility should be considered in a dog previously diagnosed with DM with progressive euglycaemia or hypoglycaemia despite tapering insulin dosage?

Answer 89

diabetic remission

Question 90

what physical examination finding is associated with poor prognosis in dogs with HAC?

Answer 90

Muscle atrophy

Question 91

what should be considered when adding canaglifozin to insulin treatment (with the aim of improving glycaemic control) in a diabetic dog?

Answer 91

reduce insulin dose due to risk of hypoglcyaemia

Question 92

what percentage of cats have resolution of hypertension after RAI treatment for hyperthyroidism?

Answer 92

49%

Question 93

Diabetic ketoacidosis was reported in what percentage of diabetic cats treated with velaglifozin?

Answer 93

7%

Question 94

what factor makes it more likely that a diabetic dog will require glargine U300 q12hrs rather than q24hrs

Answer 94

presence of concurrent dz (72% dogs with concurrent dz required BID vs 50$ dogs without concurrent dz)

Question 95

what treatment may be considered for persistent hyperkalaemic type IV renal tubular acidosis with aldosterone resistance?

Answer 95

furosemide

Question 96

Clinical signs reported in dogs with cushings do not appear to be altered by what factor?

Answer 96

weight

Question 97

permanent treatment for iatrogenic hypocortisolism is reported in what percentage of dogs?

Answer 97

25% (JAAHA paper) - 60% (JVIM paper)

Question 98

median time to resolution of ketosis was significantly shorter when compared to regular insulin CRI for which treatment protocol in dogs with DKA?

Answer 98

IM lispro

Question 99

which treatment of adrenal crisis may be associated with longer hospitalisation times?

Answer 99

hydrocortisone CRI

Question 100

what percentage of cats with acromegaly treated with cabergoline in argentina had decrease and normalisation of IGF1 and what percentage achieved DM remission? how does this compare to UK study?

Answer 100

35% decreased IGF1 and 26% normalised, 35% DM remission UK study - no change in QoL, IF1 or DM control in aero cats tx with cabergoline...

Question 101

what percentage of hyperthyroid cats have thoracic pathology on radiology and how often does it change treatment plan

Answer 101

77% thoracic pathology, mostly incidental- only 6% had change in tx plan

Question 102

what percentage of cats develop DM when receiving GCs and within what time frame?

Answer 102

9.7% cats, 85.7% within first 3 months of starting tx

Question 103

wjat percentage of cats have FSL complications? What complications are seen?

Answer 103

30% complication. 15% cats had early sensor detachment, 12% mild skin crusting/erythema and 6% skin erosion or abscess

Question 104

what percentage of non-diabetic cats with HCM have IGF1 >1000?

Answer 104

6.7%

Question 104

what effect does neutering have on plasma LH?

Answer 104

senior and geriatric neutered cats had higher plasma LH than age-matched intact cats.

Question 105

what percentage of cats receiving glargine U300 had nonclinical hypoglycaemic episodes?

Answer 105

100%