endocrine - session 16/18

Question 1

how long is NPH active for

Answer 1

intermediate acting

Question 2

how long is Lente active for

Answer 2

intermediate acting

Question 3

how long is PZI active for

Answer 3

long

Question 4

how long is glargine and detamir active for

Answer 4

long acting

Question 5

what are the preferred insulins in dogs

Answer 5

NPH & Lente

Question 6

what are the preferred insulin in cats?

Answer 6

PZI & Glargine

Question 7

Which drug inhibits the formation of functional T3 and T4 and what disease is it used to treat?

Answer 7

Methimazole

Hyperthyroidism

Question 8

Describe the species predilections for DM

Answer 8

Dog, type 1, insulin dependent

cat, type 2, remission may occur

Question 9

Which drug is a teratogen and has been associated with hypersensitivity reactions that can lead to dermatitis, vasculitis, and blood-cell dyscrasias?

Answer 9

Methimazole

Question 10

What is an adverse effect of methimazole?

Answer 10

Teratogen

Question 11

Which of the following insulin preparations can be administered IV to affect a rapid response under emergency conditions (e.g., a DKA patient)?

Answer 11

Regular crystalline insulin

Question 12

You are caring for a cat that has been taking another drug for a prior condition unrelated to its new diagnosis today of diabetes mellitus. Which of the following concurrent drugs would you be most concerned about in terms of complicating treatment of his new diagnosis?

Answer 12

glucocorticoids because the can increase insulin resistance and cause hyperglycemia

Question 13

Which drug COMMONLY causes adrenocortical cell death?

Answer 13

Mitotane

Question 14

Mitotane MOA

Answer 14

cytotoxic, causes cell death

Question 15

What frequency of dosing has been shown to BEST control clinical signs in dogs with hyperadrenocorticism?

Answer 15

every 12 hours

Question 16

What drugs can be used to treat hyperadrenocorticism?

Answer 16

Mitotane and trilostane

Question 17

When do you tell the owner to stop administering mitotane during the induction phase?

Answer 17

when they start showing signs of dec appetite

Question 18

What medication should be dispensed to patients taking mitotane in case they develop severe adverse effects?

Answer 18

prednisone can counter the adverse effects caused by rapidly declining cortisol levels

Question 19

Which of the following antifungal drugs inhibits glucocorticoid and androgen synthesis and can be used to treat hyperadrenocorticism?

Answer 19

ketoconazole

Question 20

What medication is most commonly used to treat hyperadrenocorticism in cats?

Answer 20

trilostane

Question 21

What is the treatment of choice for large pituitary tumors?

Answer 21

radiation therapy

Trilostane or mitotane may help reduce systemic signs from hyperadrenocorticism but will not help the neurologic signs caused from the tumor

Question 22

If a dog with a functional adrenal tumor is not a surgical candidate, what is the treatment of choice?

Answer 22

trilostane

Question 23

What is the preffered treatment for a dog with a functional adrenal tumor?

Answer 23

Surgery

Question 24

What is the best way to monitor adrenocortical reserve in a patient being treated for hyperadrenocorticism?

Answer 24

ACTH stim

Question 25

A 14YO MN mixed breed dog has been PU/PD, polyphagic, and panting excessively. Blood work showed a severely elevated ALP and a mildly elevated ALT. A urinalysis showed a USG of 1.004 and was otherwise unremarkable. A low dose dexamethasone suppression test was performed and is consistent with pituitary dependent hyperadrenocorticism. His blood pressure was 140mmHg. What is recommended at this time?

Answer 25

medical therapy should be started to control clinical signs and better QOL

Question 26

A 14YO CAT has been PU/PD, polyphagic, and panting excessively. Blood work showed a severely elevated ALP and a mildly elevated ALT. A urinalysis showed a USG of 1.004 and was otherwise unremarkable. A low dose dexamethasone suppression test was performed and is consistent with pituitary dependent hyperadrenocorticism. His blood pressure was 140mmHg. What is the recommendation at this time?

Answer 26

Medical therapy should be started immediately in cats.

Question 27

If the client were concerned about having to give medication daily, what would be the best medication to use?

Answer 27

Mitotane - twice a week after induction Trilostane is SID or BID

Question 28

The client is extremely concerned about adverse effects when treating hyperadrenocorticism. What medication do you recommend starting?

Answer 28

Trilostane has less effects then mitotane and is more effective then ketoconazole

Question 29

When would ketoconazole be recommended to treat hyperadrenocorticism?

Answer 29

its not

Question 30

After starting therapy for cushings, when do you recommend rechecking the patient?

Answer 30

patient should be rechecked 10-14 days after starting therapy and an ACTHST, chemistry panel and electrolytes should be performed at this time. If a patient is ever showing signs of hypoadrenocorticism, the trilostane should be stopped and an ACTHST and chemistry with electrolytes should be evaluated recheck if signs of GI upset or lethargy

Question 31

What is the treatment of choice for functional adrenal dependent hyperadrenocorticsim in dogs?

Answer 31

Surgery

Question 32

Which of the following describes the best nutritional recommendation for diabetic cats?

Answer 32

Feed a diet that is high in protein and restricted in carbohydrates, ad lib or multiple small meals each day.

Question 33

What are the best nutritional recommendation for diabetic dogs?

Answer 33

The diet should optimize body condition and minimize postprandial hyperglycemia and this may vary based on the individual dog.

Question 34

When might a spot glucose reading be helpful?

Answer 34

To ensure a patient isnt hypoglycemic

Question 35

What are commonly used insulins in dogs?

Answer 35

Lente and NPH