Endocrine Flashcards

Question

Phase 2 of the MWDT

Answer 1

Withhold food and water, empty bladder, check USG and urine osmolality, weigh patient, check BUN/crea and electrolytes Check clinical signs, weigh and check urine every 1-2 hours Bloods every 2-6 hours

Answer 2

Administer exogenous ADH if Urine has not yet concentrated IM - monitor USG every 30 mins for up to two hours Conjunctival - monitor every 1-2 hours for 8-12 hours SQ - every 1-2 hours for 8-12 hours

Answer 3

Offer small amounts of food and water every 20-30 mins for 2 hours Monitor signs and return to free choice water when patient clinically normal

Answer 4

USG >1.030 after phase 1 or 2= primary polydipsia <1.008 after phase 2 = complete CDI or congenital NDI USG after phase 3 >1.015 = CDI <1.008 after phase 3 = congenital NDI USG 1.008-1.020 after phase 2 = acquired NDI or partial CDI progress to phase three and if osmolality increases by 10-15% = CDI Osmolality = 36 x USG (1.010 = 360)

Answer 5

One drop DDAVP in conjunctival sac If NDI - hydrochlorthiazide and low sodium diet (reduced stimulation of thirst centre and water intake - reducing urine volume)

Answer 6

``` Central DI/ nephrogenic DI renal failure Cushings Addison’s Liver failure Hypercalcaemia Pyometra Septicaemia Hypercalcaemia Hyperthyroidism Hypokalaemia Acromegaly Very low protein diet Primary hyperaldosteronism fanconis syndrome Primary renal glycosuria Diabetes mellitus Post-obstructive diuresis Glucocorticoids Diuretics Phenobarbitone High salt diet Levothyroxine Vitamin D Primary polydipsia Renal medullary washout Bacterial pyelonephritis ```

Answer 7

``` DM Fanconis Primary renal glucosuria Renal failure Post obstructive diuresis ```

Answer 8

``` Primary hyperparathyroidism Renal secondary hyperparathyroidism Nutritional secondary hyperparathyroidism Vitamin D toxicity Malignancy (lymphoma, AGA, myeloma) Addison’s Young growing animal Granulomatous dz Non-malignant skeletal dz Lab error (Hyperalbuminaemia) Hyperthyroidism Grape toxicity ```

Answer 9

Reduce water intake by 10% each week Increase exercise, add another pet, increase human contact, provide a distraction eg radio

Answer 10

Pituitary corticotropin secreting tumour (80%) Rest are cortisol secreting adrenal tumours (50% malignant)

Answer 11

LDDST | UCCR

Answer 12

Adrenalectomy Medical management: Potassium gluconate Spironolactone Amlodipine

Answer 13

Porcine growth hormone injections Medroxyprogesterone acetate to stimulate mammary GH production as well as proligestone (should spay before to prevent pyometra) If concurrent hypothyroidism May need levothyroxine

Answer 14

Tetany, seizures, tremors, fasciculations, weakness/ataxia(less common), Earlier signs: facial pawing, anxiety, aggression due to muscle pain, Cataracts: immature, cortical, punctate and diffuse (characteristic of hypoparathyroidism hypocalcaemia)

Answer 15

Calcium and vitamin D supplement (needed for GI absorption Ca) Can eventually stop calcium and only give vitamin D (calcitriol and alfacidiol as these are hydroxylated forms) In emergency iv calcium gluconate 0.5-1.5mlKg IV over 10-30 minutes. Must monitor ECG for bradycardia, shortened QT interval. Risk for cardiac arrest. If vomiting stop or slow infusion Maintenance 60-90mg/kg/day do not add to lactate containing fluids as it can precipitate and don’t mix calcium and bicarbonate Can give calcium gluconate 1:1 w saline s/c q6-8 hours too after tetany has resolved and this may be easier whilst awaiting oral vitamin D to take effect Should check magnesium levels because if low hypocalcaemia can be refractory to tx

Answer 16

``` Renal/ urinary Tract dz Addison’s Severe GI disease Parasites Hepatic failure Effusions Pregnancy DM Drug induced Other - repercussion injury/haemolysis ``` If <24 highly specific for Addison’s

Answer 17

Fluids 20-30ml/kg/hr saline Give Dex if in shock Perform ACTH stim If not yet had dex now give dex or hydrocortisone Once fluid balance improved give hyrocortisone sodium succinate (dex has no mineralocorticoid activity) 0.5-0.625mg/kg/h CRI If acidotic and PH <7.2 May require bicarbonate

Answer 18

Most important tx is IV fluids Glucose IV 0.2iu/kg soluble insulin IV and dextrose 2g/unit of insulin (always measure BG after administration) Calcium gluconate 10% slowly IV monitoring ECG

Answer 19

Medical tx - 7 months - 984 days Post-adrenalectomy - good 50% Alive one year post-op but surgical mortality is high Protracted survival post-op if tumour is a carcinoma cf Adenoma

Answer 20

Measure ACTH levels - very sensitive and specific but difficult to do Better than high dose dex

Answer 21

Cats don’t have low urine specific gravity despite PU/PD ALP is often low

Answer 22

``` PUPD Anorexia Dehydration Lethargy Weakness Vomiting Pre-renal azotaemia Chronic renal failure (mineralisation likely if phos x tCa = > 5) ``` ``` Constipation Cardiac arrhythmia Seizures or twitching Death Acute renal failure Calcium urolithiasis ```

Answer 23

``` Saline 3x maintenance Furosemide once rehydrated Calcitonin (acts for around two days) Bisphosphonates Glucocorticoids (once diagnosis is reached) Bicarbonate if acidotic ``` If idiopathic often responds to high fibre diet +/- steroids

Answer 24

Parathyroid disorders: Primary hypoparathyroidism Or secondary to trauma/surgery Vitamin D disorders: Acute/chronic renal, Nutritional secondary hyperparathyroidism ``` Redistribution disorders: Puerperal tetany (eclampsia) Feline urt obstruction Sodium phosphate enemas Alkalinizing therapy Massive blood transfusion (excess of citrate products) Furosemide Ethylene glycol intoxication Pancreatitis ``` Acute renal failure - massive increase in phosphate lowering calcium

Answer 25

``` Nausea Vomiting Reflux and oesophagitis Abdominal pain Dyspesia Hypocalcaemia Hypophosphataemia Hypomagnesaemia Hypokalaemia Cost and availability ```

Answer 26

Megaoesophagus, laryngeal paralysis, haemorrhage, horners syndrome MST 3 years if mobile and 6-12 months if fixed

Answer 27

Animals with documented mets or tumours greater than 27cm^3

Answer 28

They are usually high

Answer 29

Pancreatitis, thromboembolic dz and arrhythmias

Endocrine Flashcards

(53 cards)