Exam 1- Endocrine and Neuro Flashcards Preview

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Flashcards in Exam 1- Endocrine and Neuro Deck (34):
1

What is the etiology of primary hypothyroidism?

Immune mediated destruction of thyroid cells—> aka Lymphocytic thyroiditis

2

What are the iatrogenic causes of hypothyroidism?

I-131 Tx
Antithyroid drugs
Thyroidectomy

3

What is euthyroid sick syndrome?

Syndrome where patient has non-thyroid disorder/illness which can cause abnormal thyroid function test results (will have lowered T3 level (most common) and T4 level (if severe and prolonged disease))

4

Which drugs can cause hypothyroidism?

Sulfonamides
Phenobarbital

5

What is the signalment for hypothyroidism?

Middle age to older
Medium to Large breed dogs

6

What clinical signs will you see with hypothyroidism?

Weight gain
Lethargy
Bilateral truncal alopecia
Rat Tail
Seborrhea
Hyperpigmentation
Myxedema/Myxedema coma

7

What CBC and Chem changes would you see with a hypothyroid dog?

Mild non-regenerative anemia
Hypercholesterolemia
Hypertriglyceridemia

8

True or false:
Does a normal T4 level rule out hypothyroidism?

True

9

What will the thyroid hormone and TSH levels look like in a hypothyroid dog?

Decreased T4, decreased fT4, increased TSH

10

Name of t he drug used to treat hypothyroidism

Levothyroxine

11

When should blood levels be drawn to evaluate if the therapy is working?

4-6 hours after 1st pill
Then 1 month later
**If on BID treatment

12

What disease is caused by the excessive production of T3 and T4 (thyroid hormones) due to a functional tumor?

Hyperthyroidism

13

What is the signalment of hyperthyroidism?

Older cat (mean age of 12 years old)

14

List the clinical signs of hyperthyroidism.

Weight loss
Unkempt/scraggly coat
PU/PD
GI signs: Vomting and Di

Hyperactive, tachycardic, vocalization, grumpy, ravenous appetite

15

What is apathetic hyperthyroidism?

Subset of hyperthyroid cats
-Lethargic, poor appetite, weight loss

16

What are th physical exam findings with hyperthyroidism?

Goiter, palpable thyroid slip
Tachycardia, murmur/gallop

17

What are the CBC/Chem/UA changes in a hyperthyroid cat?

Stress leukogram
Increased ALT
Increased ALP (rare)
Variable BUN, Crea, P
Isosthenuria or hyposthenuria (low USG)

18

What is the test to perform in order to get a definitive diagnosis for hyperthyroidism?

T4 level

19

What will the levels look like in a hyperthyroid cat?

Increased T4, increased fT4, decreased TSH

20

What are the non-reversible and reversible treatment options for hyperthyroidism?

Non reversible: Surgery, I-131
Reversible: Methimazole, Diet

21

What is the MOA for methimazole?

Inhibits the synthesis of thyroid hormone by blocking the incorporation of iodine

22

Why would you do a 30 day trial of methimazole before pursuing surgery in a hyperthyroid cat?

To see if azotemia is unmasked/to see if the cat will go into renal failure if the hyperthyroidism is corrected

23

What is the cause of pituitary dependent HAC?

Functional ACTH secreting pituitary tumor

24

True or false:
Adrenal dependent HAC results in bilateral adrenocortical hyperplasia.

False- Pituitary dependent HAC causes bilateral adrenocortical hyperplasia

25

How will the adrenals appear if there is an adrenal tumor present?

One normal/larger gland with contralateral gland atrophy

26

Which form of HAC causes bilateral adrenal gland atrophy??

Iatrogenic HAC, due to the excessive/prolonged use of glucocorticoids

27

What is the signalment for HAC?

Middle age to older age
Avg age of 12 years old
Seen in Poodles, Dachshunds, Schnauzers, GSDs

28

What are the 5 Ps of HAC?

Panting
Potbelly
PU/PD
Polyphagia

29

What are clinical signs you will see with a HAC patient?

Bilateral symmetrical alopecia
Muscle/ligament weakness
Calcinosis cutis
Hyperpigmentation
Resp signs: dyspnea
CNS: seizures, circling, ataxia

30

What CBC/Chem/UA changes will you see with HAC?

Stress leukogram
Increased ALP
Hypercholesterolemia
Mild hyperglycemia
Mildly increased ALT
Low USG- isosthenuria, hyposthenuria

31

True or false:
A. Positive UCCR (urine creatinine-cortisol ratio) means that the dog 100% has HAC.

False- Performing a UCCR screens for HAC and a positive result makes HAC more of a possibility (It is NOT diagnostic)

32

What response do you want to see with a LDDST?

1. 50% suppression at 8h sample =PDH
2. 4h sample is less than 1 mg/dL= PDH
3. 4h sample is 50% of baseline sample= PDH

33

True or false:
An exaggerated response (huge increase) on a ACTH stim test means that your patient has HAC.

TRUE

34

What result will you see on a ACTH stim test if the dog has iatrogenic HAC?

Diminished/suppressed response to the ACTH due to gland atrophy (can’t respond)