Endocrine Pancreas Flashcards
(29 cards)
What does each make: alpha cell, beta cell?
alpha - glucagon
beta - insulin
What are the key clinical signs for DM?
Polyuria
Polydypsia
Polyphagia
Weight loss
What signs with DM may possibly indicate a medical emergency?
decreased food and water
severe dehydration
listlessness
mental dullness
What would be the classic signalment of a DM patient?
Middle aged female
dog ~ 8 cat ~11
What are 4 laboratory patterns of hyperglycemia and Dx of DM we can use?
- Hyperglycemia + glucosuria with ketone production **
- Persistant hyperglycemia (vs. transient)
- +/- single point glucose measurements of hyperglycemia and glucosuria
- Glucose tolerance test - GTT
T/F
Ketonuria is diagnostic for DM
True
Causes of persistant hyperglycemia
How do you tell them apart based on glucose?
Diabetes (glucosuria)
hyperadrenocorticism (no glucosuria, except horse)
Less common endocrinopathy (acromegaly, hyperpituitarism
Transient causes of hyperglycemia
stress (glucocorticoids)
Excitement, fear
Post prandial
drugs
What is the glucose value with excitement in cats, horses, cows, dogs?
Cats: < 300
Horses and cow at the point of death (moribund):»_space; 300
Dogs: < 200
Why would glucosuria be seen hours after serum glucose returns to reference range?
Urine collects over time, therefore the glucose would have been collecting in the bladder hours ago/ before return to normal.
What is hyperosmolar non-ketotic diabetes?
Some release of insulin, not enough to keep glucose in ref. interval but enough to keep ketone production absent.
Glucose > 1000 w/o ketone production
What should be considered when taking a single point glucose measurement?
Species
clinical information (signs)
Supporting lab data
T/F
Excitement can produce glucosuria
True
May have glucosuria
When is a glucose tolerance test indicated?
With persistent hyeprglycemia that remains below renal threshold (no glucosuria)
What is GTT helpful for?
Regulating/trouble shooting diabetics
what two things tend to mask hypokalemia?
DM
Acidosis
What is the interesting treatment twist for a titrational metabolic ketoacidosis?
Insulin tx alone should be enough. Ketone breakdown produces HCO3. Giving HCO3 may cause alkalosis
why is it possible to have proteinuria with increase glucose?
Glucose can damage the foot process of the podocytes of the glomerulus
What is type 1 versus type 2 diabetes?
Type 1 - Decrease insulin production
Type 2 - Insulin resistance/antagonism
Is type 1 or type 2 more common in dogs? Cats?
Dogs - type 1
Cats - type 2
What is insulin resistance?
Insulin is produced but tissues are resistant
What hormones may cause insulin resistance?
Adipose tissue (endocrine organ) Glucocorticoids Inflammatory mediators Catecholamines Growth hormone Progesterone
When should you suspect insulin resistance/antagonism?
Regulation of diabetes is difficult
Other lab data warrants it (cushing’s, inflammatory disease)
What are some complications that can result from Diabetes Mellitus?
Glomerular disease (albuminuria may result)
Increased susceptibility to infections
Hepatic lipidosis
Cataracts
