Endocrinology

Question 1

What are some of the physio logic roles of Ca?

Answer 1

Neuromuscular transmission, muscle contraction, blood coag, bone, hormones

Question 2

Where is the highest percentage of extracellular Ca found?

Answer 2

Ionized or biologically active

Question 3

What are the three things that control calcium homeostasis?

Answer 3

PTH, Calcitonin, Vit D

Question 4

What is PTH secreted in response to?

Answer 4

Low Ca or high P

Question 5

What does PTH do?

Answer 5

Increases Ca mobilization from bone, renal tubular reabsorption, urinary loss of phosphorus, formation of calcitrol in kidney

Question 6

What is calcitonin secreted in response to?

Answer 6

Rise in free calcium, inhibits bone resorption of Ca

Question 7

What is the biologically active form of Vit D?

Answer 7

Calcitriol

Question 8

What are the signs of hypercalcemia?

Answer 8

May be none , PU/PD is most common also lower urinary, weakness, decreased activity.

Question 9

What are the differentials for hypercalcemia?

Answer 9

Ggranulomatous
Osteolysis
Sepsis
Hyperparathyroidsm
D toxicosis
Addisons
Renal
N eoplastic
Idioplasthic
Temperature

Question 10

What are the differentials for a patient with High Ca and Low P?

Answer 10

Primary hyperparathyroidism
hypercalcemia of malignancy
Renal disease

Question 11

What are the differentials for a patient with high Ca and high P?

Answer 11

Renal, Addison’s, hypervitaminosis D

Question 12

If the Ca-P is greater than >70 should you be concerned?

Answer 12

yes! Tissue mineralization and nephron damage

Question 13

What is the most common cause in dogs for hypercalcemia? Cats?

Answer 13

neoplasia in dogs, idiopathic in cats

Question 14

What is something on PE that you should automatically think hypercalcemia if you see?

Answer 14

Rubber jaw and urine SG

Question 15

What is primary hyperparathyroidism?

Answer 15

Syndrome of excess PTH, with clinical signs that are due to hypercalcemia. Typically from adenoma of parathyroid gland.

Question 16

What are some things that are not normal on a PHPT diagnosis?

Answer 16

high ca, low P, calcium crystals, hematuria, inflammation.

Question 17

What is the most suggestive thing an a calcium profile that is suggestive of PHPT?

Answer 17

Increased PTH in the face of hypercalcemia

Question 18

What are your treatment options for hypercalcemia? when should you treat?

Answer 18

When Ca x P>70, use fluid therapy, furosemide, glucorticoids, pamidronate

Question 19

What is the treatment of choice for PHPT?

Answer 19

Surgical parathyroidectomy

Question 20

What is one expected post surgical complication with PHPT?

Answer 20

post op hypocalcemia

Question 21

What two things should perioperative care for PHPT include and what is the aim?

Answer 21

DHT, calcitriol : both are for vitamin D therapy

Question 22

What is important in post operative care for pHPT?

Answer 22

monitor calcium frequently, slow withdrawl of treatment which should have included calcium supplementation.

Question 23

In chronic renal failure what are the Ca levels?

Answer 23

Normal

Question 24

What does renal secondary hyperparathyroidism cause?

Answer 24

progressive inability of kidneys to excrete P

Question 25

How do you differentiate Renal failure and PHPT?

Answer 25

Ca elevated but

Question 26

What do you see in hypoadrenocorticism?

Answer 26

mild hypercalcemia, P normal to increased,.

Question 27

What do you see in Vitamin D toxicity?

Answer 27

severe high Ca, significant high P, secondary renal failure, tissue mineralization

Question 28

What is idiopathic hypercalcemia? And what animal is it seen in?

Answer 28

Sustained serum Ca rise of unknown cause in cats.

Question 29

What are some things you can see with hypocalcemia?

Answer 29

seizures, ataxia, weakness, tetany ,muscle cramping.

Question 30

What are the three categories of hypoparathyroidism?

Answer 30

absence or destruction of parathyroid sudden correction of chronic hypercalcemia impaired secretion or tissue response to PTH

Question 31

What are the 4 major treatments for hypoparathy.?

Answer 31

Calcium supplementation, calcitrol, magnesium, thiazide diruretics

Question 32

What are the other 8 things that can cause hypocalcemia?

Answer 32

eclampsia, renal failure, pancreatitis, hypomagnesemia, malabsorption, hypovitD, lab error, blood transfusion.

Question 33

In birds what is the separate gland that produced calcitonin?

Answer 33

Ultimobranchial gland

Question 34

What is different about the cortisol that birds and reptiles produce?

Answer 34

It is corticosterone

Question 35

What are the three secondary endocrine dz that you see in birds and reptiles?

Answer 35

NSHP

Question 36

What is Nutritional secondary hyperparathyroidism?

Answer 36

Deficiency of Ca++, Vit D3, UVB light, excess P. You see a compensatory rise in PTH

Question 37

What is another name for NSHP?

Answer 37

Metabolic bone disease

Question 38

What is renal secondary hyperparathyroidism?

Answer 38

Increased PTH in response to low Ca++ and hyperphosphatemia

Question 39

What is RSHP more common in?

Answer 39

Older lizards

Question 40

What are some clinical signs with metabolic bone disease?

Answer 40

rubbery flexible bones, fibrous osteodystrophy, fractures, skeletal deformities. Hypocalcemia in end stages.

Question 41

What is the best treatment for metabolic bone disease?

Answer 41

correct the diet, UVB light, Vit. D3, calcitonin, cage rest, manage fractures.

Question 42

What is goiter or thyroid dysplasia caused by?

Answer 42

Iodine deficiency or excess

Question 43

What are some clinical signs of goiter in tortoises in budgerigars?

Answer 43

Bud: Voice changes, wheezing, esophageal compression Tort:Large swellings at base of ventral neck

Question 44

What are the primary endocrine dz of birds?

Answer 44

Gastric neuroendocrine carcinoma and functional endocrine tumors

Question 45

What do you normally see gastric neuroendocrine carcinoma in?

Answer 45

Bearded dragons

Question 46

What are the CS of GNC?

Answer 46

hyperglycemia, anorexia, weight loss, anemia.

Question 47

What axis does the thyroid gland operate on?

Answer 47

hypothalamic, pituitary, thyroid axis.

Question 48

What are the three types of hypothyroidism? What parts do they effect?

Answer 48

Primary: thyroid gland: most common Secondary: pituitary/TSH-rare tertiary: TRH deficiency: not reported