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

Endocrinology (1-8) Flashcards

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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
name 3 clinical signs of feline hyperthyroidism
1. weight loss 2. increased appetite 3. PU/PD
26
name 3 clinical signs for a cat with apethetic hyperthyroidism (~10% of cases)
1. decr. appetite 2. lethargic 3. weakness
27
what should be palpable on physical exam of a cat with hyperthyroidism (in 80-95% of cases)
palpable goitre
28
name 3 differential diagnoses for feline hyperthyroidism
1. chronic kidney disease 2. Diabetes mellitus 3. primary cardiac disease
29
name the concurrent disease that may develop when treating incr. T4 (feline hyperthyroidism)
chronic kidney disease
30
how to confirm hyperthyroidism in a cat?
total T4
31
name 2 medication options for medical management of feline hyperthyroidism
1. Methimazole (Thiamazole) 2. Carbimazole (methimazole in vivo)
32
name the 4 long term management options for feline hyperthyroidism
1. medical management 2. dietary management 3. surgical thyroidectomy 4. radioactive iodine | (3 & 4 are curative, 1 & 2 not)
33
how often is on-going monitoring of a cat being/was treated for hyperthyroidism recommended
every 3-6 months
34
name 4 possible complications of a thyroidectomy
1. recurrence 2. laryngeal paralysis 3. hypocalcaemia (hypoparathyroidism) 4. hypothyroidism
35
what to supplement for hypoparathyroidism following thyroidectomy?
calcium + vitamin D supplementation
36
name the 3 forms that calcium is found in within the plasma
1. physiologically active ionised form (50%) 2. chelated form (10%) 3. protein bound form (40%)
37
what 3 things can the chelated form of calcium be complexed with in plasma
1. lactate 2. citrate 3. bicarbonate
38
# name the hormone increases renal absorption of calcium; causes osteoclasts to release calcium from the skeleton
parathyroid hormone (PTH)
39
# name the hormone secreted by the thyroid gland; decreases bone resorption and lowers calcium concentration
calcitonin
40
# 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
1,25 dihydroxyvitamin D (1,25 Vit D)
41
why is polyuria and polydipsia seen with hypercalcaemia?
due to ADH inhibition
42
name the 2 most common neoplastic causes of hypercalcaemia in dogs
1. anal sac adenocarcinoma 2. lymphoma (LSA)
43
name 4 common causes of hypercalcaemia in dogs
1. neoplasia 2. renal disease 3. hypoadrenocorticism 4. parathyroid disease
44
name 3 common causes of hypercalcaemia in cats
1. idiopathic (50%) 2. neoplasia 3. renal disease
45
# name the cause of hypercalcaemia often present with tenesmus, rectal mass, anorexia, PU/PD, lethargy; tends to metastases early
anal sac adenocarcinoma
46
name 3 treatment options if the calcium is high in an emergency situation
1. IV fluid to promote calciuresis 2. furosemide once hydrated 3. bisphosphonates (inhibit osteoclasts)
47
name the 6 most common causes of hypocalcaemia
1. hypoalbuminaemia 2. chronic renal failure 3. pancreatitis 4. eclampsia 5. idiopathic or iatrogenic hypoparathyroidism 6. protein losing enteropathies
48
name the 3 parts of the adrenal cortex
1. zona glomerulosa 2. zona fasiculata 3. zona reticularis
49
where are mineralocorticoids (aldosterone) produced within the adrenal cortex
zona glomerulosa
50
where are glucocorticoids (cortisol) produced within the adrenal cortex
zona fasiculata
51
where are sex hormones (androgens) produced within the adrenal cortex
zona reticularis
52
where are catecholamines (adrenaline and noradrenaline) produced in the adrenal gland?
adrenal medulla
53
# name the disease syndrome caused by excessive amounts of glucocorticoids in the body
hyperadrenocorticism (Cushing's Syndrome)
54
what 3 specific tests should be done to screen for hyperadrenocorticism
1. urine cortisol:creatinine ratio 2. ACTH stimulation test 3. low dose dexamethasone suppression test
55
what two tests can be done to differentiate between pituitary dependent hyperadrenocorticism (PDH) and adrenal dependent hyperadrenocorticism (ADH)?
1. ACTH assay 2. imaging (abdominal +/- head)
56
how to perform ACTH stimulation test
5 µg/kg ACTH IV; cortisol measured at 0 and 1 hours
57
how to perform low dose dexamethasone suppression test?
0.01 mg/kg dexamethasone IV; cortisol measured 0, 4, 8 h
58
name the only licensed product to treat canine hyperadrenocorticism in the UK; blocks production of glucocorticoids
Trilostane (Vetoryl)
59
what is the treatment of choice for adrenal dependent hyperadrenocorticism
adrenalectomy
60
what are the two treatment options for a pituitary mass casing hyperadrenocorticism
1. radiation therapy 2. hypophysectomy
61
# 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
hypoadrenocorticism
62
name 4 common routine clinicopathological features of hypoadrenocorticism seen on haematology
1. non-regenerative anaemia 2. eosinophilia 3. lymphocytosis 4. lack of stress leukogram
63
name 5 common routine clinicopathological features of hypoadrenocorticism seen on serum biochemistry
1. azotaemia 2. hypercalcaemia 3. hyperkalaemia 4. hyponatraemia 5. hypocholesterolaemia
64
name 2 screening tests for hypoadrenocorticism
1. resting cortisol 2. UCCR (Urinary cortisol:creatinine ratio)
65
name 2 treatment options for acute hypoadrenocorticism
1. Dexamethasone 2. Hydrocortisone CRI
66
what drug can be used for hormone replacemet of glucocorticoids in chronic hypoadrenocorticism
prednisolone
67
name the two drug options for replacement of mineralocorticoids in chronic hypoadrenocorticism
1. DOCP 2. fludrocortisone
68
# name the disease a syndrome characterised by hyperglycaemia that results from defects in insulin secretion or insulin sensitivity in target tissues OR both
Diabetes mellitus (DM)
69
what pancreatic islet cell secretes glucagon (25% of cells)
alpha cells
70
what pancreatic islet cell secretes insulin (60% of cells)
beta cells
71
what pancreatic islet cell secretes somatostatin (10% of cells)
delta cells
72
what pancreatic islet cell secretes polypeptide
F cells or PP cells
73
name 5 clinical signs of Diabetes mellitus (DM)
1. PU/PD 2. polyphagia 3. weight loss 4. cataracts/blindness (dogs) 5. DKA signs (diabetic ketoacidosis)
74
what is the concentration of veterinary insulin preparations?
40 IU/mL
75
what is the concentration of human insulin preparations?
100-300 IU/mL
76
name 4 common complications of feeding high-fiber diets to dogs
1. increased frequency of defecation 2. contipation and obstipation 3. soft to watery stools 4. excessive flatulence
77
what is the starting insulin dose for cats
0.25 IU/kg
78
name 3 treatment options for hypersomatotropism in diabetic cats
1. increase insulin 2. transphenoidal hypophysectomy 3. radiotherapy
79
# name the disease presence of ketones indicative of insufficient insulin; can be relatively well or feeling ill
ketosis
80
# name the disease presence of ketones to a large extent overwhelming normal buffering; patients will be ill and require emergency care
ketoacidosis
81
what 2 things are important to monitor in an electrolyte panel for a patient with suspected diabetic ketoacidosis
1. potassium 2. phosphate | (both will be low)
82
name the 4 most common places of metastases for an insulinoma
1. liver 2. lymph nodes 3. mesentery 4. omentum
83
name 3 differential diagnoses for hypoglycaemia
1. insulinoma 2. hypoadrenocorticism 3. hepatic disease
84
what is the emergency treatment for an insulinoma?
IV dextrose to effect (not too quickly) & feed as soon as able
85
what drug can be given for medical management of an insulinoma to antagonise insulin
prednisolone
86
# 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
ADH / Vasopressin
87
what is the treatment for diabetes insipidus
DDAVP (synthetic vasopressin)
88
name 4 types of tumours that can arise from the adrenal gland
1. glucocorticoid producing 2. aldosterone producing 3. non-functional 4. catecholamine producing
89
# name the type of adrenal tumour catecholamine producing; in the medulla
pheochromocytoma (dogs)
90
what are the clinical signs caused by with a pheochromocytoma
excessive catecholamine production
91
name the 3 locations where pheochromocytomas often metastasise to
1. lung 2. liver 3. bone
92
what is the medical treatment for pheochromocytoma
phenoxybenzamine (alpha-blocker)
93
how much body weight should you aim to lose weekly for a cat
1-2% body weight/week
94
how much of the cardiac output does the kidney recieve?
20%
95

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