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Endocrine System Diseases Flashcards

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1
Q

What is the main trigger of the Endocrine System?

A

hypothalamus

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2
Q

What are Endocrine Glands?

A
  • basic units of the endocrine system
  • secrete hormones directly into the bloodstream
  • ductless
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3
Q

What are Exocrine Glands?

A

units that secrete their products onto epithelial surfaces through tiny tubes called ducts

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4
Q

What are Hormones?

A

chemical messengers produced by -endocrine glands and secreted directly into blood vessels
-produce effects when they find their receptors in or on cells

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5
Q

What is Negative Feedback?

A
  • endocrine glands stimulated to produce more hormone when it drops below a certain level
  • if hormone level is adequate, gland either slows or stops production
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6
Q

What is Direct Stimulation of Nervous System?

A

secretion of some hormones is stimulated by sympathetic nerve impulses when an animal feels threatened

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7
Q

What are the 2 diseases of the Thyroid Gland?

A

hyperthyroidism

hypothyroidism

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8
Q

Where is the Thyroid Gland located?

A

ventral cervical region along lateral margins of trachea

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9
Q

What hormones are produced by the Thyroid Gland?

A

T3 (triiodothyronine)
T4 (tetraiodothyronine thyroxine)
Calcitonin

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10
Q

What cells in the Thyroid Gland produce T3 and T4?

A

follicular cells

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11
Q

What cells in the Thyroid Gland produce Calcitonin?

A

parafollicular cells

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12
Q

What are T3 and T4?

A

iodine containing hormones

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13
Q

What is the function of Calcitonin?

A

causes calcium deposition in bone which decreases blood calcium concentration

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14
Q

What is Hypothyroidism?

A

clinical state associated with deficency of T4, which causes low cell metabolism in most tissues of the body

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15
Q

What % of dogs acquire Hypothyroidism?

A

90%

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16
Q

What is Primary Acquired Hypothyroidism caused by?

A

idiopathic follicular atrophy
lymphocytic thyroiditis
iodine deficiency, neoplasia, infection

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17
Q

What is the cause of Secondary Acquired Hypothyroidism?

A

RARE

anterior pituitary dysfunction or destruction from neoplasia

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18
Q

What is the most common Endocrine Disease in Dogs?

A

Hypothyroidism

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19
Q

What breeds does Hypothyroidism commonly affect?

A

golden retrievers, doberman, irish setter, schnauzer, cocker spaniel, dachshund

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20
Q

What is the signalment for Hypothyroidism?

A

4-10 yrs old

females

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21
Q

What are the common c/s of Hypothyroidism?

A 
weight gain w/out diet change
skin changes
cold intolerance
lethargy/sleeping
exercise intolerance
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22
Q

What Skin Changes can occur with Hypothyroidism?

A 
bilaterally symmetric truncal alopecia
alopecia of tail, neck, axillae and other areas of friction
seborrhea
superficial pyoderma
dry, lustless haircoat
hyperpigmentation
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23
Q

What are less common c/s of Hypothyroidism?

A 
neuropathies (generalized weakness, ataxia, facial paralysis/paresis, seizures)
GI (constipation, regurgitation caused by megaesophagus)
bloodwork abnormalities ( hyper lipemia, gross lipemia, hyper cholesterolemia)
eye(hyperlipidemia, corneal lipidosis)
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24
Q

How do you diagnose Hypothyroidism?

A

blood tests

hypothyroid dogs have lowered levels of T4

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25
What are some considerations with Hypothyroidism?
sick animals and animals on certain meds may have low T4 levels (euthyroid sick syndrome)
26
What breed of dog has naturally low T4 levels?
greyhound
27
How do you treat Hypothyroidism?
``` thyroid supplement (l-thyroxine) oral, synthetic levothyroxine ```
28
What is client info for Hypothyroidism?
supplement for life daily dosing required overdose=hyperthyroidism reduced fat diet (if overweight)
29
What is Hyperthyroidism?
pathologic, sustained, high overall metabolism caused by high circulating concentrations of thyroid hormone
30
What is the pathophysiology of Hyperthyroidism?
autonomously hyperfunctioning nodules no physiologic controls (functional thyroid adenoma) secrete T3 and T4
31
What are c/s of Hyperthyroidism?
``` weight loss polyphagia vomiting/diarrhea PU/PD tachypnea/dyspnea hyperactivity aggression tachycardia hypertension poor body condition thickened nails unkempt appearance large palpable gland ```
32
How do you diagnose Hyperthyroidism?
palpate enlarged thyroid gland elevated T4, FT4 x rays for associated heart disease
33
How do you treat Hyperthyroidism?
methimazole (tapazole) radioiodine treatment (#1)-emitted radiation destroys functioning follicular cells surgical removal of gland
34
What are complications of Hyperthyroidism?
renal disease/failure unveiled when thyroid levels controlled (2-3 months after meds) tapazole may not be effective after 2-3 years of treatment
35
What is the prognosis for Hyperthyroidism?
excellent if uncomplicated | if labs show azotemia prior to treatment, prognosis is guarded
36
What is client info for Hyperthyroidism?
cause is unknown surgery and radiation only cures cat may become hypothyroid following Rx after tapazole, blood pressure and kidneys should be checked
37
What are the 2 diseases of the Parathyroid Glands?
hyperparathyroidism | hypoparathyroidism
38
What is secreted from the Parathyroid Gland?
parathyroid hormone (PTH)
39
What is the primary cause of Hyperparathyroidism?
adenoma or carcinoma
40
What is the secondary cause of Hyperparathyroidism?
poor diet;low Ca intake
41
What are c/s for Hyperparathyroidism?
``` many animals show no c/s urinary/renal calculi cardiac arrhythmias, tremors anorexia, vomiting, constipation weakness ```
42
How do you diagnose Hyperparathyroidism?
``` chemistry panel (increased blood calcium, decrease phosphorus) PTH assay (elevated) ultrasound of neck (enlarged glands, abdomen-uroliths) ```
43
How do you treat Hyperparathyroidism?
surgical removal of dz parathyroid gland ultrasound guided chemical (ethanol) ultrasound guided heat (laser) ablation
44
What is post op care for Hyperparathyroidism?
hospitalize for 1 wk calcium therapy vitamin D supplements
45
What are causes of Hypercalcemia?
``` neoplasia renal failure hypoadenocorticism vitamin D rodenticide poisioning drugs or artifacts ```
46
What are c/s of Hypercalcemia?
``` PU/PD anorexia lethargy vomiting weakness stupor/coma uroliths ```
47
How do you diagnose Hypercalcemia?
elevated serum calcium levels | low to low-normal phosphorus concentrations
48
How do you treat Hypercalcemia?
fluids (0.9% NaCl) diuretics (furosemide) steroids
49
What are complications associated with Hypercalcemia?
irreversable renal failure | soft tissue calcifications
50
What are causes of Hypocalcemia?
``` parathyroid disease (removal of parathyroid gland accidentally #1) chronic renal failure puerperal tetany (eclampsia) ```
51
What are c/s of Hypocalcemia?
``` restlessness, muscle tremors, tonic-clonic contractions, seizures tachycardia with excitement bradycardia in severe cases hyperthemia stiffness, ataxia ```
52
How do you diagnose Hypocalcemia?
total serum <6.5 mg/dl
53
How do you treat Hypocalcemia?
iv infusion of 10% Ca gluconate solution diazepam (iv) to control seizures oral supplements of Ca improve nutrition
54
What is the function of Insulin?
moves glucose into cells to be used for energy | decreases blood glucose
55
What is the function of Glucagon?
raises blood glucose stimulates liver to release glucose stimulates gluconeogenesis
56
What is Hyperglycemia?
excessively high blood glucose levels
57
What is the normal glucose level in dogs?
60-120 mg/dl
58
What is the normal glucise level in cats?
70-150 mg/dl
59
What is Diabetes Mellitus?
disorder of carbs, fats and protein metabolism caused by an absolute or relative insulin deficiency
60
What is Type 1 DM?
insulin dependent | very low or absent insulin secretory ability
61
What is Type 2 DM?
non insulin dependent | inadequate or delayed insulin secretion relative to the needs of the patient
62
What are the causes of DM?
chronic pancreatitis | immune mediated diseases (beta cell destruction)
63
What are predisposing/risk factors of DM?
``` cushing's acromegaly obesity genetic predisposition drugs (steroids) ```
64
What age/sex does DM affect most?
dogs: 4-14, females 2x more likely cats: all ages, but 75% are 8-13yrs, neutered males
65
What breeds does DM affect most?
poodles, schnauzers, keeshonds, cairn terriers, dachshunds, cockers, beagles
66
When do c/s of DM develop?
exceeds capacity of renal tubular cells to reabsorb dogs: BG > 180-220 mg/dl cats: BG >200-280 mg/dl
67
What systems does DM affect?
``` endocrine/metabolic hepatic opthalamic renal/urologic nervous musculoskeletal ```
68
What are c/s of DM?
``` polyuria polydipsia polyphagia weight loss dehydration cataract formation (dogs) plantigrade stance (cats) ```
69
What is Diabetic Ketoacidosis?
true medical emergency secondary to absolute or relative insulin deficiency causing hyperglycemia, ketoemia, metabolic acidosis, dehydration and electrolyte depletion
70
How is Diabetic Ketoacidosis diagnosed?
ketones in urine or in blood
71
What are c/s of Diabetic Ketoacidosis?
``` all of the DM signs depression weakness tachypnea vomiting odor of acetone on breath ```
72
How do you treat Diabetic Ketoacidosis?
IV fluids 0.9% NaCl regular insulin to decrease BG monitor BG q 2-3hrs when BG is normal, switch to long acting insulin
73
How do you diagnose Diabetic Ketoacidosis?
``` CBC biochem panel UA low electrolytes blood gases fructosamine levels ```
74
What diet should a dog with DM be placed on?
high fiber, complex carbs | slows digestion, reduces post prandial glucose spike, promotes weight loss, reduces risk of pancreatitis
75
What diet should a cat with DM be placed on?
high protein, low carbs
76
What oral hypoglycemics should be used in treatment of DM?
sulfonylureas-glipizide (cats) | alpha glucosidase inhibitors (dogs)
77
What is client info for DM?
lifelong insulin replacement therapy refridgerate insulin, mix gently if animal doesn't eat - no insulin
78
What is Hypoglycemia?
low blood glucose levels
79
What are causes of Hypoglycemia?
``` neonatal and juvenile septicemia neoplasia starvation iatrogenic - insulin overdose portosystemic shunt ```
80
What are causes of Insulin Shock?
insulin overdose too much exercise anorexia
81
What are c/s of Insulin Shock?
weakness incoordination seizures coma
82
How do you prevent Insulin Shock?
consistant diet/consistent exercise monitor urine/blood glucose at same time each day feed 1/3 insulin, the rest 8-10hrs later have sugar supply handy
83
What is the cause of Insulinoma?
tumor of beta cells, secreting excess insulin
84
What are c/s of Insulinoma?
``` prolonged hypoglycemia weakness ataxia muscle fasiculations posterior paresis brain damage seizures coma death ```
85
How do you diagnose Insulinoma?
``` chem panel (low glucose, high insulin) observations (symptoms occur after fasting or exercise) ```
86
How do you treat Insulinoma?
removal of tumor acute at home (administer glucose) acute at hosp ( adm. glucose 50% dextrose) chronic care (3-6 small meals/day, glucocorticoid therapy, diazoxide, octreotide injections)
87
What is EPI?
exocrine pancreas insufficiency | inability to process nutrients efficiently due to lack of production of enzymes from pancreas
88
What breeds is EPI most commonly found?
german shepherds | rough collies
89
Where is EPI most commonly a result of in cats?
chronic pancreatitis
90
When is EPI usually evident?
when 85%-90% of pancreas is unable to secrete enzymes
91
What are c/s of EPI?
weight loss, no change in diet or appetite persistant tarry diarrhea flatulence poor haircoat
92
How do you test for EPI?
TLI ( trypsin-like immunoreactivity) | detects trypsin and trypsinogen
93
How do you treat EPI?
enzymatic supplements | viokase powder
94
What is client info for EPI?
life long treatment expensive can be well controlled should not be bred
95
What are the 2 diseases of the Adrenal Glands?
cushing's (hyperadrenocorticism) | addison's (hypoadrenocorticism)
96
What is Cushing's Disease?
hyperadrenocorticism | disorder caused by deleterious effects of high circulation cortisol concentrations on multiple organ systems
97
What organ systems are affected by Cushing's?
``` renal skin cardiovascular respiratory endocrine/metabolic musculoskeletal nervous reproductive ```
98
What are the effects of excess glucocorticoids?
suppress inflammation suppress immune system inhibit cartilage growth, development and repair
99
What are c/s of Cushing's?
``` bilaterally symmetrical alopecia pot belly pyoderma PU/PD muscle wasting thin coat calcinosis cutis abnormal gonadal function ```
100
Where is Calcinosis Cutis usually seen?
dorsal midline ventral abdomen inguinal region skin is usually thin and atrophic
101
How do you diagnose Cushing's?
``` chem panel ( increased ALP, ALT, CHOL, BG, decreased BUN, lipemia, low USG) urine cortisol/creatinine ratio (normal = no cushings, elevated = cushings) ```
102
What are the 3 tests to diagnose Cushing's?
ACTH stimulation test low dose dexamethason suppression test high dose dexamethasone suppression test
103
What is the ACTH stimulation test?
normal pt. show increase of plasma cortisol pituitary dependant diseases : excess ACTH release adrenal tumors (exaggerated cortisol response) doesn't differentiate between pit disease and adrenal tumor
104
What is the Low Dose Dexamethasone Suppression Test?
inject low dose of steroid measure plasma cortisol at 0, 4, 8 hrs Interpretation: normal= decrease, pit and adrenal tumors = no affect @ 8hrs
105
What is the High Dose Dexamethasone Suppression Test?
0.1 mg/kg IV collect plasma cortisol at 0,4,8 hrs Interpretation: pit. disease= 70-75% show decrease at 4 or 8hr, adrenal tumor=no change
106
How do you treat Cushing's?
``` sugical removal (not pituitary) medical treatment: lysodren (necrosis of z fasiculata, z reticularis) ```
107
What is an alternative to Lysodren?
trilostane | less side effects
108
What is Addison's Disease?
hypoadrenocorticism disorder caused by deficient production of glucocorticoids (cortisol) or mineralocorticoids (aldosterone) or both secondary disease caused by chronic admin of corticosteroids
109
What are c/s of Addison's?
``` due to mineralcorticoid (aldosterone) deficiency lethargy, weakness, anorexia, wt. loss vomiting/diarrhea PU/PD, dehydration bradycardia ```
110
How do you diagnose Addison's?
Na:K ratio increased BUN, CREA and Ca++ decreased blood glucose and albumin ACTH stimulation (normal = increase cortisol, abnormal= low, unchanged cortisol levels)
111
How do you treat Addison's?
acute crisis ( normal saline, glucorticoid replacement: dexamethasone or prednisone, mineralocorticoid replacement: florinef, percortin)
112
How do you treat chronic Addison's?
glucocorticoid replacement : prednisone, predisolone mineralocorticoid replacement : florinef, percortin V monitor electrolytes, BUN/CREA, c/s

Canine And Feline Clinical Management (10 decks)

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