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Clinical Sciences > Exam 1 - Endocrine > Flashcards

Exam 1 - Endocrine Flashcards

1
Q

common signs of diabetes mellitus

different signs in dogs vs cats

A

weight loss
polyphagia
PUPD
cataracts (dogs)
frosty paws/plantigrade stance/neuropathies (cats)
recurrent infections
hepatomegaly

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2
Q

clinicopathologic findings of diabetes mellitus

A

hyperglycemia
glucosuria
elevated cholesterol
elevated liver enzymes
min concentrated urine

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3
Q

dogs get what type of DM?
cats?

A

dogs type I
cats type II

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4
Q

can cats get type I DM?

A

yes - with chronic insulinemia
beta cells produce amylin > amyloid > destroys beta cells = no more production of insulin (NOT immune mediated)

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5
Q

recommended dietary components for glycemic control in dogs and cats

A

dogs - complex carbs + exercise
cats - protein, low carbs

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6
Q

dog insulin recommendation

A

vetsulin/lente or NPH given SQ twice daily
intermediate-acting

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7
Q

cat insulin recommendation

A

PZI or glargine given SQ twice daily
long-acting

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8
Q

insulin recommendation for DKA patient

A

regular insulin once a day given IM or CRI
short-acting

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9
Q

what should be monitored in a diabetic patient

A

clinical signs - watch for decrease PUPD, decrease appetite, weight loss stabilization, weight gain if thin

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10
Q

lab results to monitor in diabetic patients

A

urine dipstick - glucose and ketones
spot glucose reading
+/- fructosamine

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11
Q

what lab data should you acquire if DM is poorly regulated

A

minimum database (CBC, biochem, UA)
glucose curve

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12
Q

insulin dose in dogs & cats
when do you worry about insulin resistance

A

dogs 0.25-1.25 units/kg/dose
cats 1-5 units/dose

IR in dogs > 1.5 units/kg/dose
IR in cats > 5 units/dose

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13
Q

DKA clinical signs

A

lethargy, anorexia, vomiting, dehydration, shock
history of weight loss, polyphagia, PUPD

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14
Q

DKA clinpath abnormalities

A

hyperglycemia
azotemic (pre-renal)
acidosis
increased liver enzymes
hypoNa/Cl
hyperkalemia
glucosuria & ketonuria

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15
Q

initial diagnostics for DKA patient

A

venous blood gas
urine dipstick

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16
Q

recommended therapy for DKA patient

A

1 fluids & electrolytes to correct acidosis

insulin + glucose
identify triggers (counter-reg hormones)

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17
Q

why monitor P & K in a DKA patient

A

after treatment - intracellular shift
hypokalemia - muscle weakness (e.g. cervical ventroflexion)
hypophosphatemia - hemolysis/anemia

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18
Q

precursor for all adrenal product

A

cholesterol

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19
Q

what enzyme converts cholesterol/11-deoxycorticosterone → aldosterone

A

aldosterone synthase

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20
Q

what enzyme converts cholesterol/11-deoxycorticosterone → cortisol, DHEA, androstenedione

A

17𝛼-hydroxylase

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21
Q

clinical signs of Cushing’s disease

(primarily dogs)

A

PUPD
polyphagia
weight gain
muscle wasting or redistribution to abdomen “pot belly” & nape of neck
hypertension
immunosuppression/infections
alopecia/calcinosis cutis
stress leukogram (increased neut/mono, decrease lymp/eos)
hepatomegaly w/ increased ALP, cholesterol & glucose
low USG
bacteriuria w/o pyuria

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22
Q

what screening tests can you do for Cushing’s

A

urine-cortisol:creatinine ratio to rule out
ACTH stim (only test for iatrogenic)
LDDST

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23
Q

what discriminatory tests can you do for Cushing’s

A

LDDST
HDDST
endogenous ACTH
imaging - US, CT, MRI

24
Q

treatment for PDH Cushing’s

A

trilostane
stereotactic radiosurgery (SRS)

25
Q

treatment for ADH Cushing’s

A

trilostane
adrenalectomy

26
Q

clinical signs of Addison’s disease

A

usually young-middle aged female w immune-mediated disease

waxing/waning illness
lethargy & anorexia/weight loss
vomiting
bloody diarrhea
regurgitation w/ megaesophagus
hypotension
lack of stress leukogram
anemia due to chronic disease
PUPD
shock
increased ALT
decreased cholesterol, glucosem albumin
increased K, Ca, P, BUN, Cr & decreased NaCl and bicarbonate if aldosterone affected
low USG

27
Q

typical vs atypical Addison’s disease

A

typical - cortisol & aldosterone low (thus will have kidney signs - PUPD, azotemia, hyperkalemia, acidosis, low USG)
atypical - cortisol low only (vomit, diarrhea, painful abd)

28
Q

Ddx for typical addison’s

A

acute kidney injury

29
Q

Ddx for atypical Addison’s

A

GI foreign body
pancreatitis
acute hemorrhagic diarrhea syndrome (AHDS)

30
Q

what Na:K ratio rules in Addison’s disease

A

< 21:1

31
Q

what test can rule out Addison’s disease

A

baseline cortisol > 2 = no addison’s

32
Q

how can you recognize an Addisonian EKG

A

no P wave
wide QRS complex
spiked T wave

33
Q

how to treat Addison’s disease esp the hyperkalemia

A

1 fluids

replace glucocorticoids w/ Dexamethasone
correct hyperkalemia with fluids, insulin + glucose, calcium gluconate, or bicarb (allows for K+ intracellular shift)

34
Q

therapy treatment for Addison’s disease, what glucocorticoid? what mineralocorticoids?

A

glucocorticoid: prednisone

mineralocorticoids:
DOCP + prednisone
Florinef +/- prednisone

35
Q

clinical signs of hyperthyroidism (cats)

A

PUPD, weight loss + polyphagia
tachycardia +/- murmurs or arrhymias
hypertension
nervousness, hyperactivity, aggression
unkempt haircoat
muscle wasting, fat loss
tachypnea
increased ALT, ALP, glucose, BUN
decreased USG

36
Q

Name the other common diseases that cause PU/PD, polyphagia and weight loss in cats.

A

diabetes mellitus

37
Q

Name the common disease that causes PU/PD and weight loss with decreased appetite in cats.

A

CKD

38
Q

best test to screen a cat for hyperthyroidism? why?

what other tests can you do?

A

total t4
very specific

fT4 or nuclear scintigraphy - technetium [99m-Tc]

39
Q

treatment for cats with hyperthyroidism

A

iodine deficient diet
methimazole
thyroidectomy
I-131

40
Q

mechanism of radioactive I-131 treatment

A

healthy atrophied thyroid cells do not take up I-131
active cells are destroyed
healthy cells remain and will eventually start to produce T4 again in 1-6 months

41
Q

what do you use to treat hyperthyroidism sequelae such as hypertension/hypertensive retinopathies (hemorrhage or detachment)

A

Ca2+ channel blocks - amlodipine

42
Q

clinical signs of hypothyroidism (dogs)

A

mental dullness
decreased reflexes, paresis, cranial n deficits “tragic face”
alopecia
weight gain w/ normal/decreased appetite
non-regenerative anemia
hypercholesterolemia

NO PUPD or polyphagia

43
Q

how would you test a dog for hypothyroidism

A

tT4 (+/- fT4) & eTSH

44
Q

treatment for hypothyroidism

A

L-thyroxine twice daily
monitor tT4 6-8 weeks post therapy and 4-6 hours post-pill

45
Q

causes of hypercalcemia

A

“gosh darn it”
granulomatous (fungal)
osteolytic (tumor)
spurious (lipemia, hemolysis, hemoconcentration, hyperalbuminemia, acidosis, young animal)
hyperparathyroidism
vitamin D toxicosis
addison’s disease
renal secondary hyperparathyroidism
neoplasia
idiopathic in cats
toxins

46
Q

clinical signs of hypercalcemia

A

PUPD
weakness
listlessness
inappetence
cardiac arrhythmias
calcium oxalate stones
+/- UTI

47
Q

clinical signs of hypocalcemia

A

muscle fasciculations/tetany
pruritus/facial rubbing
panting
nervousness
seizures
cardiac arrhythmias

48
Q

most common differential diagnoses for PUPD

A

primary polydipsia
secondary nephrogenic DI
osmotic diuresis

49
Q

osmotic diuresis ddx for PUPD

A

diabetes mellitus
post-obstructive diuresis
CKD
fanconi’s syndrome

50
Q

secondary nephrogenic DI ddx for PUPD

A

hyperadrenocorticism
hypoadrenocorticism
hyperthyroidism
pyometra
hypercalcemia

51
Q

primary polydipsia ddx for PUPD

A

hyperthyroidism
hyperadrenocorticism
hepatic disease

52
Q

what is the cutoff for polydipsia

A

> 60-80 ml/kg/day

53
Q

polyphagia with weight loss ddx

A

food quality, exercise, growing, pregnant
hypermetabolism or nutrient loss

54
Q

weight gain with increased appetite ddx

A

treats, exercise, new stressor, client communication
hyperadrenocorticism
insulinoma
growth hormone
pregnancy
drug

55
Q

weight gain with decreased appetite ddx

A

hypothyroidism in dogs
hypothalamic dz
age
Female > male
castrating
breeds
treats
edema, ascites, intra-abdominal mass, organomegaly

56
Q

causes of anorexia

A

brain
mouth
primary GI
secondary GI

57
Q

counter-regulatory hormones of insulin

A

epinephrine
cortisol
progesterone
growth hormone
glucagon
thyroid hormone

Clinical Sciences (12 decks)

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