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Cat & Dog > Endocrinology (1-8) > Flashcards

Endocrinology (1-8) Flashcards

1
Q

what hormone is produced in the largest amount by the thyroid gland?

A

thyroxine (T4)

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2
Q

what hormone stimulates T4 production by the thyroid?

A

TSH
(thyroid stimulating hormone)

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3
Q

what is the major active Thyroid hormone?

A

T3

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4
Q

name the thyroid hormone

99% protein bound in the blood;
protein bound form acts as a reservoir to maintain steady state concentration of free form

A

T4

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5
Q

where is the majority of T3 derived from?

A

extrathyroidal enzymatic deiodination of T4

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6
Q

name the site of pathology in primary hypothyroidism

A

thyroid

(common)

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7
Q

name the site of pathology in secondary hypothyroidism

A

pituitary

(very rare)

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8
Q

name the site of pathology in tertiary hypothyroidism

A

hypothalamus

(very very rare)

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9
Q

name 3 causes of primary acquired hypothyroidism in dogs

A
  1. Lymphocytic thyroiditis (autoimmune)
  2. idiopathic follicular atrophy
  3. neoplasia
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10
Q

name 3 dog breeds with an increased risk of primary acquired hypothyroidism

A
  1. boxers
  2. dobermann pinscher
  3. border terrier
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11
Q

name 3 dog breeds with a decreased risk of primary acquired hypothyroidism

A
  1. frenchies
  2. yorkies
  3. pugs
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12
Q

what are the two main categories of clinical signs for primary acquired hypothyroidism in dogs

A
  1. metabolic
  2. dermatological
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13
Q

name 3 metabolic clinical signs of primary acquired hypothyroidism in dogs

A
  1. lethargy
  2. weight gain
  3. exercise intolerance

(NOT PU/PD)

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14
Q

name 5 dermatological clinical signs of primary acquired hypothyroidism in dogs

A
  1. alopecia
  2. pyoderma
  3. seborrhea
  4. dry/poor quality coat
  5. hyperpigmentation
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15
Q

name a consistent change on serum biochemistry that is seen with primary acquired hypothyroidism in dogs

A

increased lipids
(triglycerides and cholesterol)

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16
Q

what clinical sign to the following Ddx have in common?

  • hypothyroidism
  • hyperadrenocorticism
  • Diabetes mellitus
  • pancreatitis
  • cholestasis
  • hepatic insufficiency
  • protein-losing enteropathy
A

hyperlipidaemia

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17
Q

name the endocrine test

very good initial screen for hypothyroidism in patients with compatible clinical signs;
if normal, hypothyroidism is effectively ruled out;
may be falsely elevated in dogs with anti-antibodies;
sighthounds have a lower amount

A

TT4
(total T4)

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18
Q

name the drug

can cause disturbed thyroid function

A

Trimethoprim-sulfonamides

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19
Q

name the drug

can alter T4 and TSH concentrations;
T4 significantly decr & TSH significantly increased

A

Phenobarbitone

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20
Q

name the drug

can alter T4 and TSH concentrations;
can decr. T4 with normal TSH

A

glucocorticoids

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21
Q

name the cause of low TT4

in response to almost any systemic illness, surgery or trauma:
* body decr. TSH & therefore signal for T4 release
* physiologic adaptation that decr. cellular metabolism during illness

low TT4 and normal TSH

A

sick euthyroid

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22
Q

name the endocrine test

50% of hypothyroid dogs are positive for this;
these are found in dogs with lymphocytic thyroiditis

A

TgAA
(thyro-globulin auto-antibodies)

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23
Q

what is the treatment of choice for dogs with primary acquired hypothyroidism?

A

Levothyroxine

(0.02-0.04 mg/kg PO q12/24h)

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24
Q

when should the TT4 concentrations and clinical signs be checked to assess the response of a dog with hypothyroidism to Levothyroxine treatment?

A

4-8 weeks after starting meds;
4-6 h after giving med in morning

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25
Q

name 3 clinical signs of feline hyperthyroidism

A
  1. weight loss
  2. increased appetite
  3. PU/PD
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26
Q

name 3 clinical signs for a cat with apethetic hyperthyroidism (~10% of cases)

A
  1. decr. appetite
  2. lethargic
  3. weakness
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27
Q

what should be palpable on physical exam of a cat with hyperthyroidism (in 80-95% of cases)

A

palpable goitre

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28
Q

name 3 differential diagnoses for feline hyperthyroidism

A
  1. chronic kidney disease
  2. Diabetes mellitus
  3. primary cardiac disease
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29
Q

name the concurrent disease that may develop when treating incr. T4 (feline hyperthyroidism)

A

chronic kidney disease

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30
Q

how to confirm hyperthyroidism in a cat?

A

total T4

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31
Q

name 2 medication options for medical management of feline hyperthyroidism

A
  1. Methimazole (Thiamazole)
  2. Carbimazole (methimazole in vivo)
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32
Q

name the 4 long term management options for feline hyperthyroidism

A
  1. medical management
  2. dietary management
  3. surgical thyroidectomy
  4. radioactive iodine

(3 & 4 are curative, 1 & 2 not)

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33
Q

how often is on-going monitoring of a cat being/was treated for hyperthyroidism recommended

A

every 3-6 months

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34
Q

name 4 possible complications of a thyroidectomy

A
  1. recurrence
  2. laryngeal paralysis
  3. hypocalcaemia (hypoparathyroidism)
  4. hypothyroidism
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35
Q

what to supplement for hypoparathyroidism following thyroidectomy?

A

calcium + vitamin D supplementation

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36
Q

name the 3 forms that calcium is found in within the plasma

A
  1. physiologically active ionised form (50%)
  2. chelated form (10%)
  3. protein bound form (40%)
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37
Q

what 3 things can the chelated form of calcium be complexed with in plasma

A
  1. lactate
  2. citrate
  3. bicarbonate
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38
Q

name the hormone

increases renal absorption of calcium;
causes osteoclasts to release calcium from the skeleton

A

parathyroid hormone (PTH)

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39
Q

name the hormone

secreted by the thyroid gland;
decreases bone resorption and lowers calcium concentration

A

calcitonin

40
Q

name the regulator of calcium

increases calcium absorption from the intestines;
has effects on bone and kidney to increase calcium levels;
formed by successive hydroxylation in the liver and kidneys

A

1,25 dihydroxyvitamin D
(1,25 Vit D)

41
Q

why is polyuria and polydipsia seen with hypercalcaemia?

A

due to ADH inhibition

42
Q

name the 2 most common neoplastic causes of hypercalcaemia in dogs

A
  1. anal sac adenocarcinoma
  2. lymphoma (LSA)
43
Q

name 4 common causes of hypercalcaemia in dogs

A
  1. neoplasia
  2. renal disease
  3. hypoadrenocorticism
  4. parathyroid disease
44
Q

name 3 common causes of hypercalcaemia in cats

A
  1. idiopathic (50%)
  2. neoplasia
  3. renal disease
45
Q

name the cause of hypercalcaemia

often present with tenesmus, rectal mass, anorexia, PU/PD, lethargy;
tends to metastases early

A

anal sac adenocarcinoma

46
Q

name 3 treatment options if the calcium is high in an emergency situation

A
  1. IV fluid to promote calciuresis
  2. furosemide once hydrated
  3. bisphosphonates (inhibit osteoclasts)
47
Q

name the 6 most common causes of hypocalcaemia

A
  1. hypoalbuminaemia
  2. chronic renal failure
  3. pancreatitis
  4. eclampsia
  5. idiopathic or iatrogenic hypoparathyroidism
  6. protein losing enteropathies
48
Q

name the 3 parts of the adrenal cortex

A
  1. zona glomerulosa
  2. zona fasiculata
  3. zona reticularis
49
Q

where are mineralocorticoids (aldosterone) produced within the adrenal cortex

A

zona glomerulosa

50
Q

where are glucocorticoids (cortisol) produced within the adrenal cortex

A

zona fasiculata

51
Q

where are sex hormones (androgens) produced within the adrenal cortex

A

zona reticularis

52
Q

where are catecholamines (adrenaline and noradrenaline) produced in the adrenal gland?

A

adrenal medulla

53
Q

name the disease

syndrome caused by excessive amounts of glucocorticoids in the body

A

hyperadrenocorticism
(Cushing’s Syndrome)

54
Q

what 3 specific tests should be done to screen for hyperadrenocorticism

A
  1. urine cortisol:creatinine ratio
  2. ACTH stimulation test
  3. low dose dexamethasone suppression test
55
Q

what two tests can be done to differentiate between pituitary dependent hyperadrenocorticism (PDH) and adrenal dependent hyperadrenocorticism (ADH)?

A
  1. ACTH assay
  2. imaging (abdominal +/- head)
56
Q

how to perform ACTH stimulation test

A

5 µg/kg ACTH IV;
cortisol measured at 0 and 1 hours

57
Q

how to perform low dose dexamethasone suppression test?

A

0.01 mg/kg dexamethasone IV;
cortisol measured 0, 4, 8 h

58
Q

name the only licensed product to treat canine hyperadrenocorticism in the UK;
blocks production of glucocorticoids

A

Trilostane (Vetoryl)

59
Q

what is the treatment of choice for adrenal dependent hyperadrenocorticism

A

adrenalectomy

60
Q

what are the two treatment options for a pituitary mass casing hyperadrenocorticism

A
  1. radiation therapy
  2. hypophysectomy
61
Q

name the disease

umbrella term for a range of naturally-ocurring or iatrogenic disorders that cause reduced function of the adrenal cortex and results in a state of glucocorticoid deficiency, mineralocorticoid deficience, or both

A

hypoadrenocorticism

62
Q

name 4 common routine clinicopathological features of hypoadrenocorticism seen on haematology

A
  1. non-regenerative anaemia
  2. eosinophilia
  3. lymphocytosis
  4. lack of stress leukogram
63
Q

name 5 common routine clinicopathological features of hypoadrenocorticism seen on serum biochemistry

A
  1. azotaemia
  2. hypercalcaemia
  3. hyperkalaemia
  4. hyponatraemia
  5. hypocholesterolaemia
64
Q

name 2 screening tests for hypoadrenocorticism

A
  1. resting cortisol
  2. UCCR (Urinary cortisol:creatinine ratio)
65
Q

name 2 treatment options for acute hypoadrenocorticism

A
  1. Dexamethasone
  2. Hydrocortisone CRI
66
Q

what drug can be used for hormone replacemet of glucocorticoids in chronic hypoadrenocorticism

A

prednisolone

67
Q

name the two drug options for replacement of mineralocorticoids in chronic hypoadrenocorticism

A
  1. DOCP
  2. fludrocortisone
68
Q

name the disease

a syndrome characterised by hyperglycaemia that results from defects in insulin secretion or insulin sensitivity in target tissues OR both

A

Diabetes mellitus (DM)

69
Q

what pancreatic islet cell secretes glucagon
(25% of cells)

A

alpha cells

70
Q

what pancreatic islet cell secretes insulin
(60% of cells)

A

beta cells

71
Q

what pancreatic islet cell secretes somatostatin
(10% of cells)

A

delta cells

72
Q

what pancreatic islet cell secretes polypeptide

A

F cells or PP cells

73
Q

name 5 clinical signs of Diabetes mellitus (DM)

A
  1. PU/PD
  2. polyphagia
  3. weight loss
  4. cataracts/blindness (dogs)
  5. DKA signs (diabetic ketoacidosis)
74
Q

what is the concentration of veterinary insulin preparations?

A

40 IU/mL

75
Q

what is the concentration of human insulin preparations?

A

100-300 IU/mL

76
Q

name 4 common complications of feeding high-fiber diets to dogs

A
  1. increased frequency of defecation
  2. contipation and obstipation
  3. soft to watery stools
  4. excessive flatulence
77
Q

what is the starting insulin dose for cats

A

0.25 IU/kg

78
Q

name 3 treatment options for hypersomatotropism in diabetic cats

A
  1. increase insulin
  2. transphenoidal hypophysectomy
  3. radiotherapy
79
Q

name the disease

presence of ketones indicative of insufficient insulin;
can be relatively well or feeling ill

A

ketosis

80
Q

name the disease

presence of ketones to a large extent overwhelming normal buffering;
patients will be ill and require emergency care

A

ketoacidosis

81
Q

what 2 things are important to monitor in an electrolyte panel for a patient with suspected diabetic ketoacidosis

A
  1. potassium
  2. phosphate

(both will be low)

82
Q

name the 4 most common places of metastases for an insulinoma

A
  1. liver
  2. lymph nodes
  3. mesentery
  4. omentum
83
Q

name 3 differential diagnoses for hypoglycaemia

A
  1. insulinoma
  2. hypoadrenocorticism
  3. hepatic disease
84
Q

what is the emergency treatment for an insulinoma?

A

IV dextrose to effect (not too quickly)
& feed as soon as able

85
Q

what drug can be given for medical management of an insulinoma to antagonise insulin

A

prednisolone

86
Q

name the hormone

released in response to increased blood osmolarity [Na+];
goes to the kidneys and increases water resorption;
constricts arterioles and increases arterial blood presssure

A

ADH / Vasopressin

87
Q

what is the treatment for diabetes insipidus

A

DDAVP
(synthetic vasopressin)

88
Q

name 4 types of tumours that can arise from the adrenal gland

A
  1. glucocorticoid producing
  2. aldosterone producing
  3. non-functional
  4. catecholamine producing
89
Q

name the type of adrenal tumour

catecholamine producing;
in the medulla

A

pheochromocytoma
(dogs)

90
Q

what are the clinical signs caused by with a pheochromocytoma

A

excessive catecholamine production

91
Q

name the 3 locations where pheochromocytomas often metastasise to

A
  1. lung
  2. liver
  3. bone
92
Q

what is the medical treatment for pheochromocytoma

A

phenoxybenzamine
(alpha-blocker)

93
Q

how much body weight should you aim to lose weekly for a cat

A

1-2% body weight/week

94
Q

how much of the cardiac output does the kidney recieve?

A

20%

95
Q
A

Cat & Dog (19 decks)

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