Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 4 small animal > Endocrine Diseases > Flashcards

Endocrine Diseases Flashcards

(54 cards)

Start Studying
1
Q

Effects of insulin

A

Inhibits ketogenesis
Stimulates glucose uptake
Stimulates K+ uptake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the difference between type 1 and type 2 diabetes mellitus

A

Type 1 - beta cell production leading to insulin deficiency. Immune mediated and idiopathic
Type 2 - ranges predominantly insulin resistance to a secretory defect with/without resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Source of issues for type 1 diabetes

A

Pancreatectomy
Pancreatitis
Auto-immunity
Islet cell hypoplasia
Chemical toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Source of issues for type 2 diabetes

A

Progesterone/agen
Growth hormone
Glucocorticoids
Glucagon
Catecholamines
Thyroid
Obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Aetiology of type 1 diabetes mellitus

A

Immune mediated - antibodies in circulation against Islet
Beta islet cell loss due to epi/pancreatitis
Congenital beta islet cell loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Aetiology of type 2 diabetes mellitus

A

Progesterone - an acromegaly
Hyperadrenocorticism
Exogenous steroids
IGF1/GH excess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pathophysiology of diabetes mellitus

A

Polyuria/polydipsia - osmotic diuresis
Polyphagia - insulin in cns stops the hypothalamic satiety centre
Weight loss/exercise intolerance/ lethargy due to NEB and reduced glucose and amino acid uptake
Recurrent infections - immunological compromise and favour of microbial growth
Ketotic breath
Cataracts due to osmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Presentation of diabetes mellitus

A

Dull, depressed, weak, possibly comatose
Vomiting
Dehydrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common lab findings in diabetes mellitus

A

Urinalysis - glucosuria
Increased ALKP/ALT
Increased cholesterol/triglycerides
Fasting hyperglycemia
Can have hyponatraemia, ketonuria, ketonaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Diagnosis of diabetes mellitus

A

Hyperglycemia - fasting hyperglycemia. >12mmol/L usually, 5.5-12mmol/L more challenging diagnosis
Glucosuria - 10-12mmol/L
Ketonuria
Fructosaminev>400mmol/L highly suggestive of DM (false negatives possible)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment for diabetes mellitus

A

Insulin - type and frequency
Diet
Body condition
Lifestyle
Spaying at appropriate time
Consider owner factors - finances/commitment etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 2 types of licensed insulin for dogs

A

Caninsulin - intermediate acting, usually twice daily, initially at 0.5ui/kg
Prozinc - protamine zinc insulin, BID in cats and SID in dogs. Most require 0.8-1.2iu/kg/dose to stabilize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Care factors for insulin

A

Must be kept 2-8°
Do not shake but roll
Beyond expiry can be ineffectual
Discard after 28 days use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Care with diet with diabetes mellitus

A

Consistent diet and timing important
Need to be high in complex carbohydrates to minimize glucose peaks
High fibre
Avoid semi moist foods
Need consistent exercise similarly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you start treating diabetes

A

Start insulin giving 0.5 iu/kg SC bid
Make sure diet is correct/consistent
Get owner to monitor water intake
Re see in 7 days
If not controlled increase dose 10% and re check in 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diabetes mellitus monitoring options

A

Owner at home
Blood glucose curves
Other
- fructosamine (aim for 400-450nmol/L)
- glycated haemoglobin (4-6% stabilized, 7%+ poorly stabilized)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Complications of diabetes mellitus

A

Hypoglycaemia
Hunger, food seeking, ataxia, weakness, collapse, convulsions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

clinical signs of hyperthyroidism

A

goiter (98%)
increased appetite
vomiting
hyperactivity
weight loss
pu/pd
diarrhoea/increased faecal volume
muscle wasting
thin bcs
tachycardia >240
heart murmur
hypertension
agressive/reduced stress tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what classes as a thyroid crisis

A

exaggerated thyrotoxicosis
severe tachycardia >300pbm
tachypnoea
panting
respiratory distress
profound weakness
ventro-flexion
sudden blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Tests for hyperthyroidism

A

specific
total t4 - increased in 90-05% hypert cats, will fluctuate and suppressed by non-thyroidal disease
free t4 - unbound, can diffuse into the cell, more sensitive. increased chance of false positive
t3 - active thyroid hormone, derived from t4 in extrathyroidal tissues
tsh - non thyroidal illness will affect
scintigraphy
non-specific
haematology/biochemistry for concurrent disease/secodnary hepatopahty
urinalysis - specific gravity, normally very high >1.035 and hyperthyrodism increases GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

treatment options for hyperthyroidism

A

radioactive iodine 131 - aim for euthyroid not hypo
surgery - most have bilateral disease. need to take care to lead blood supply to parathyroids or imbed in muscle.
anti-thyroid medication
ultra-low iodine diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

reasons to perform scintigraphy

Study These Flashcards
A

confirms hyperthyroid
excludes diagnosis in euthyroid cats
identifies disease pattern
identifies ectopic tissue
aids diagnosis of carcinoma

23
Q

considerations for radioactive iodine

Study These Flashcards
A

131I administered SC
can only be done with specific licensing/hospitalisation
cats become radioactive

24
Q

anti-thyroid medication

Study These Flashcards
A

carbimazole - prodrug or methimazole
stops incorporation of iodine into pre-thyroid proteins
reactions
- non-life-threatening - anorexia, vomiting, lethargy, face and neck excoriation
- life threatening - dyscrasia (leukaemia, anaemia, thrombocytopaenia) hepatopathy

25
ultra low iodine diet
no iodine = no thyroid hormone produced manages but does not cure disease good when treatment not possible or with side effects to anti-thyroid med issues - must be fed exclusively
26
Pathophysiology of diabetic ketoacidosis
reduced insulin = reduced cellular glucose uptake = metabolic deficit glucagon.....acetoacetate and beta hydroxybutyrate are acidic leading to metabolic acidosis
27
history/CE for diabetic ketoacidosis
often new diabetic diagnosis, middle aged-older. PUPD not resolving, weight loss continuing. lethargy, anorexia and V+. often dehydrated/hypovolaemic Abdo pain, hepatomegaly, reduced BCS, mental dullness
28
Diagnosis of diabetic ketoacidosis
diabetes - hyperglycaemia/glucosuria ketones - B-hydroxybutyrate, blood ketones ideals, urine tests metabolic acidosis - blood gas machine for EPOC/iSTAT anaemia/left shift neutrophilia common elevated ALP/ALT electrolyte derangements common
29
treatment of diabetic ketoacidosis
hypovolaemia/dehydration - aggressive fluid therapy (hartmanns), monitor electrolytes(2-4hourly) pseudo-hyperkalaemia - comes down a lot with fluid therapy Hypophosphataemia - cri potassium phosphate hyponatraemia hypocalcaemia - fluid therapy hypomagnemaesia - magnesium cri (indicated if vomiting over maropitant) Hyperlgycaemia - measure once hydrated and control with insulin CRI Condsider - analgesia, anti-emetics Dogd - hyperadrenocorticism, pancreatitis, UTI Cats - hepatic lipidosis, CRF, pancreatitis, bacterial/viral infection, neoplasia, acromegaly
30
hyperglycaemic, hyperosmolar syndrome
rare but important similar to DKA hyperglycaemia-osmotic diuresis-haemoconcentration - hyperglycaemia dx - BG>33.3mmol/l, absence of ketones Treatment - fluid therapy over 24-48 hours, not quick as dont want osmotic gradient across BBB max reduction <3mmol/l/h
31
hyperadrenocorticism
80-90% are pituitary dependent - micro and macro adenomas/adenocarcinomas 10-20% adrenal dependent - adrenal adenomas/carcinomas iatrogenic - steroids
32
canine hyperadrenocorticism
middle age/older dogs female more common PUPD polyphagia muscle wasting, weakness, pot belly, panting skin thinning, calcinosis cutis, pigmentation, bruising, symmetrical hair loss
33
Hyperadrenocorticism diagnosis
radiography - hepatomegaly, pot belly, calcinosis cutis, distended bladder, tracheal/bronchial wall mineralisation, pulmonary metastasis, osteoporosis haematology - stress leukogram (neutrophilia, lymphopaenia, monocytosis, absolute eosinopaenia) - question HAC diagnosis if any of these opposed Biochemistry - increased ALP, ALT, hyperglycaemia, eleveated phosphorus, increased cholesterol/triglycerides Urinalysis - <1.030 despite mild dehydration - above this HAC unlikely
34
hyperadrenocorticism endocrine tests
low dose dexamethasone - dexamethasone given over 50% response = pituitary acth response - give ACTH, at 1h >500-600nmol/l is positive. steroid therapy reduces response urinary cortisol:creatinine ratio - urine samples - urine samples at home, unstressed steroid induce alkaline phosphatase
35
consideration for diabetics with HAC
treat DM first as cannot reply on usual markers in a diabetic
36
adrenal imaging for HAC
Pituitary dependent - symmetrical enlargement adrenal dependent - one enlarged and one atrophied adrenal
37
HAC treatment
medial - trilostane is licensed, only works for 6-8 hours surgical - adrenalectomy for ADH or hypophysectomy for PDH(very scarcely available)
38
SID HAC therapy
preserve mineralocorticoid function allows some negative feedback to mitigate increases in pituitary ACTH output or enlargement
39
phaechromocytoma
can be confused for hyperadrenocorticism dx - urinary catecholamine metabolities, histology post surgery treatment - surgery, medical - adrenoreceptor antagonists, phenoxylbenzamine, propanolol.
40
normal calcium controls
many exchanges between gut, plasma, skeleton and kidneys
41
how is calcium distributed
between ionized, bound and complexed calcium
42
renal secondary hyperparathyroidism
fgf-23, decreased calcitriol and reduced calcium absorption leads to increased PTH hyperphosphataemia leads to increased complexed calcium serum total calcium = normal-high ionised low
43
hypercalcaemia causes
increased PTH activity - activity of PTH like substances increased vitaminD activity (drives calcium into circulation) osetolysis - calcium from bone other/unclear mechanism
44
causes of total hyperCa
dogs - malignancy, hyperadrenocorticism, primary hyperparathyroidism, CRF, vit D toxicosis, granulomatous disease cats - idiopathic, renal failure, malignancy, primary hyperparathyroidism HARDIONS/HOGSINYARD
45
idiopathic hypercalcaemia
young-middle aged cats mild-moderate hypercalcaemia no obvious atiology - hypercalcaemia, normal phosphorus, intact PTH, PTHrp undetectable, normal vitd3
46
investigations of hypercalcaemia
CS - PUPD, vomiting, anorexia, muscle weakness, dehydration review history - diet supplements etc breed - keeshond very common clinical signs - lymph nodes, anal sac masses, neoplasias, parathyroid imaging, angiostrongylus, bloods
47
azotaemic hypercalcaemia
elevated urea,creatinine, tCa and phosphorus which came first? renal dysfunction - elevated total calcium elevated calcium - renal dysfunction
48
parathyroid hormone + ionised calcium
serum pth+serum ionised calcium both low = primary hypoparathyroidism high serum pth, low to normal ionised calcium - secondary hyperparathyroidism low serum PTH and high ionised calcium - pth independent hypercalcaemia high serum PTH, high ionised calcium - primary hyperparathyroidism
49
25-hydroxy vitamin d
hydroxylation occurs in liver great indication of dietary sufficiency use for suspected cholecalciferol intoxification rule out dietary misinformation
50
1,25 dihydroxy vitamin D
1a hydroxylation in renal tubules lower with reduced renal tubular mass in pathogenesis of secondary hyperparathyroidism
51
hypercalcaemia treatment
fluids/diuresis - 5ml/kg/hr NaCl determine by Ca:P ratio furosemide once hydrated glucocorticoids - prednisolone 1mg/kg bisphosphonates- stop calcium removal from bone
52
parathyroid adenoma
hyperactive parathyroid will cause atrophy of the other glands can very quickly lead to hypocalcaemia monitor post surgery and support with calcium supplementation aim for subclinical hypocalcaemia to stimulate remaining tissue
53
hypocalcaemia
parathyroid dependent demands exceeds supply/mobilisation eg periparturient tetany, nutritional deficiency, pancreatitis clinical presentation - head rubbing, muscle fasiculations, stiff, ataxic, biting/licking at paws, agitated dx - history/routine labs tx - iv calcium, borogluconate etc, long term aim for low-normal hypocalcaemia
54
what does fructosamine indicate
blood glucose over the last 1-3 weeks not effected by stress can be normal in mild or recent diabetics

Year 4 small animal (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions