Exam review

Question 1

Cyclosporin does not suppress the BM and works on IL___ and the main SE is ….

Answer 1

Cyclosporin does not suppress the BM and usually has GI side effects, works on IL-2 and the main SE is GI upset but can also cause gingival hyperplasia

Question 2

What are some causes for increased bilirubin?

Answer 2

prehepatic- Intravascular (like hemolysis), hepatic (liver failure so unable to break it down), and post hepatic like cholestasis

Question 3

What enzyme/value of serum chemistry tells you about liver function and NOT damage?

Answer 3

ALP (half life is very long, like weeks to months and can be elevated due to many, many things!!!!)

Question 4

What enzyme/value on serum chemistry tells you about liver damage but not function?

Answer 4

ALT (half life is 60 hours in dog and 4-6 hours in a cat)

Question 5

HCM notes to know–

Answer 5

Left atrium dilated because left ventricle gets larger and atria does not handle well with high pressure so it will hypertrophy and when left atrium gets big enough it creates “smoke” signs on echo with turbulent blood flow

Question 6

What is involved in the breakdown of a blood clot?

Answer 6

FDP’s, uses up antithrombin so that gets decreased, and D-dimers are used

Question 7

What is directly involved with rat bait toxicity? (I am looking for an enzyme here)

Answer 7

Vitamin K epoxide reductase which is the enzyme that is involved with anti-coagulating with rat bait toxicity

Question 8

What elevates first with anti coag toxicity?

Answer 8

PT because involves factor 7 which has the shortest half life

Question 9

Hyperadrenocorticism is usually pituitary dependent or adrenal dependent?

Answer 9

Pituitary dependent

Question 10

___% of pit tumors are microadenomas (tumor of the pituitary gland in the brain and are less than 1cm) that turn into MACRadenomas

Answer 10

20%

Question 11

When can you see proteinuria without any other urinalysis abn?

Answer 11

Amyloidosis (think sher peis) and glomerulonephritis (can have normal BUN in these p but WILL HAVE loss of proteins in the urine)

Question 12

Know all about LLDST and HDDST

Answer 12

..

Question 13

Normal calcium in animals is __-__ on serum chem and is VERY VERY VERY VERY VERY VERYYY TIGHTLY REGULATED

Answer 13

like 9.4- 11

even 0.1 off is something to dive deeper into….

Question 14

GSD with weight loss despite normal appetite 6 y/o MN is likely NOT what disease???

Answer 14

hyperadrenocorticism

Question 15

Primary hyperparathyroidism calcium and phosphorus levels…

Answer 15

high calcium and low phosphorus

Question 16

What will iron def look like in terms of MCV and MCHC?

Answer 16

Microcytic micro chromic

Question 17

____ is always artifact on MCHC

Answer 17

Hyperchromic (cannot get more hgb into cells than they already have….)

Question 18

What will MCV and MCHC look like in terms of NON- regenerative anemia???

Answer 18

Normocytic and normochromic

Question 19

What will MCV and MCHC look like in terms of regenerative anemia???

Answer 19

Hypercytic normochromic

Question 20

What is an open pneumothorax?

Answer 20

Open wound in the chest wall

Question 21

IMHA will have ____

Answer 21

bilirubinuria

Question 22

bloodwork findings most consistent with ethylene glycol toxicity

Answer 22

metabolic acidosis, elevated anion gap, high osmolal gap, and calcium oxalate crystals

Question 23

Dogs with addison’s disease labwork

Answer 23

Monocytosis (stress leukogram),…

Question 24

The least likely CS of dogs with diabetes mellitus is _____

Answer 24

neuropathy

They will usually be pu/pd/polyphagic with weight loss

Question 25

Dogs with dehydration may have what findings on labwork?

Answer 25

Elevated PCV, pre renal azotemia so increased BUN and creatinine

Question 26

Stomach worm

Answer 26

Called Physaloptera and migrates throughout stomach and duodenum and can even go in a little further than that, usually free swimming but can attach and CAUSES CHRONIC VOMITING!!!!

Question 27

T/F canine scabies responds very well to medications

Answer 27

True!!!

Question 28

what worm can migrate to the eye?

Answer 28

Hookworms

Question 29

Live function tests

Answer 29

Tbilirubin, glucose, Cholesterol, BUN, albumin

Question 30

Cushings disease CS and labwork findings–

Answer 30

Pu/pd, stress leukogram, elevated ALP, LOW USG, bladder and/or kidney stones, panting, bot belly, hair thinning, alopecia

Question 31

ALP

Answer 31

ALP is how much the cells are turned on, does not mean liver damage/injury, can be increased with steroid use, older dogs, etc. So we usually do not get too concerned about high ALP even if moderate to marked because it can be influenced by many things

Question 32

Clues to liver failure

Answer 32

Hypercoagulable, high ALT Low BUN Increased Tbili
Elevated globulins Elevated or decreased cholesterol
Hypoalbuminemia
Hypoglycemia

Question 33

What regulates calcium in the body?

Answer 33

Parathyroid hormone (PTH) and calcitonin

If PTH goes up then calcium goes up because it is mobilized from the bone (increased osteoclast activity) and increases absorption from the GI tract via vitamin D from the kidneys, if calcitonin goes up then calcium in the blood stream decreases

Question 34

HOGS IN YARD or HARD IONS

Answer 34

Primary hyperparathyroidism
Neoplasia - lymphoma, multiple myeloma, osteosarcoma, AGASACA, mammary carcinomas Granulomatous disease- Fungal disease- blastomycosis and coccidiomycosis aka Valley fever are the most common
Also schizomycosis and heterobilarzia
Viral disease in cat causing granulomatous lesion- FIP
Renal disease causing secondary hyperparathyroidism
Vitamin D toxicosis
Over supplementation/diet, eczema creams, through the sun, rat bait toxicity with vit D active ingredient
Vitamin A toxicity
Addison’s disease –> HYPERKALEMIA, HYPONATREMIA, HYPOCHOLREMIA
Growing animal (will also look like it has slight anemia, increased BUN because growing)

Question 35

Tx high calcium

Answer 35

Diuresis USE SODIUM CHLORIDE AKA SALINE FLUIDS FOR THIS, furosemide, bisphosphates, steroids
Management- calcium gluconate, sodium bicarbonate, dextrose/glucose and insulin, fluids of diuresis, terbutaline 0.01

Question 36

Bloodwork with Addison’s Disease–

Answer 36

Low sodium, high potassium, cortisol levels below <2, high PCV (dehydration)/pre-renal azotemia, may have low glucose (may be refractory to treatment- has to do with how cortisol impacts gluconeogenesis), acidotic, hyperphosphatemia from decreased GFR/dehydration, hypercalcemia (could also be low)- mostly we see normal calcium so it basically does whatever it wants and follows trends of other electrolytes in that patient
Baseline cortisol less than 2, may have reversed stress leukogram

Question 37

T/F Because dogs with atypical Addison’s disease have signs of glucocorticoid deficiency only, they require glucocorticoid supplementation only

Answer 37

True!!!

Dogs with just e’lyte abn need just mineralocorticoid supplementation

Question 38

Adjust ____ in addisons dogs based on stressful events

Answer 38

Glucocorticoid

Question 39

LDDST

Answer 39

4 hour post- if cortisol is <1.4 then NO cushings dz,
8 hour post- if cortisol is > 1.4, consistent with cushing’s disease but unsure if it is PD or AD

Question 40

ACTH stim test

Answer 40

post samples
> 22 =cushings positive
17-22 = borderline
< 22= WNL, no cushings disease

Question 41

LDDST

Answer 41

Draw baseline cortisol
check at 9 hours first, if > 50% of the baseline AND if it is more than 1.5 then it is cushings
then check 4 hour if it is under 1.5 and then goes back up for 8 hour OR < 50% baseline then it is suppressed and is cushings and is likely PITUITARY DEPENDENT

Question 42

Most animals have ____ dependent cushings disease, esp. if they are ____ (size) dogs

Answer 42

Pituitary dependent; small breed dogs

Question 43

cushings disease can cause what other findings on work up?

Answer 43

Hepatomegaly, bladder stones/kidney stones, UTI, abn sized adrenals in some cases, hypercoaguloapthy with high BP

Question 44

adrenal and pituitary dependent cushings disease TX

Answer 44

Trilostane (Vetoryl)

Question 45

1. Both adrenal glands large =
2. One adrenal gland small and the other large=
3. Both adrenal glands small=

Answer 45

1. both large= pituitary
2. one small, one large = adrenal most likely
3. both adrenals small = Addison’s disease or iatrogenic with steroid use