Glucose and Lipids

Question 1

What stimulates the secretion of insulin?

Answer 1

Increased blood glucose levels and increased GH levels.

Question 2

What processes does insulin stimulate?

Answer 2

Glucose uptake in cells, glycogen storage, and cellular uptake of potassium, phosphate, and magnesium into cells.

Question 3

What processes does insulin inhibit?

Answer 3

Glucose production (glycogenolysis and gluconeogenesis) and lipolysis of adipose tissue.

Question 4

Decreased levels of blood glucose leads to __________ lipolysis.

Answer 4

Increased.

Question 5

What stimulates the secretion of growth hormone?

Answer 5

Decreased blood glucose levels.

Question 6

Growth hormone _________ blood glucose concentrations.

Answer 6

Increases.

Question 7

Corticosteroids _________ blood glucose concentrations.

Answer 7

Increase.

Question 8

Glucagons _________ blood glucose concentrations.

Answer 8

Increases.

Question 9

What is a hallmark of transient or sustained hyperglycemia?

Answer 9

Glucosuria (blood glucose levels have exceeded renal threshold).

Question 10

What are the four categories of hyperglycemia?

Answer 10

1. Physiological (excitement or fright) 2. Pathologic (diabetes mellitus) 3. Pharmacologic/Toxicologic (dextrose, ethylene glycol) 4. Transient.

Question 11

What are two examples of transient hyperglycemia?

Answer 11

1. Sepsis 2. Proximal duodenal obstruction (adult cattle with diseases resulting in decreased abomasal outflow).

Question 12

What bloodwork changes can you see with diabetes mellitus?

Answer 12

Hyperglycemia, glucosuria, hypercholesterolemia, hypertriglyceridemia, and ketonuria.

Question 13

What is diabetic ketoacidosis?

Answer 13

A severe state of hyperglycemia where the lack of insulin causes massive breakdown of stored fat and release of free fatty acids.

Question 14

Which five main conditions cause hypercholesterolemia?

Answer 14

1. Liver disease and cholestasis 2. Diabetes mellitus 3. Pancreatitis 4. Hyperadrenocorticism 5. Hypothyroidism.

Question 15

Which three main conditions cause hypertriglyceridemia?

Answer 15

1. Diabetes mellitus 2. Hyperadrenocorticism 3. Hypothyroidism.

Question 16

What will you see in the blood with hypertriglyceridemia?

Answer 16

A milky appearance in the serum.

Question 17

What are the two main causes of increased insulin secretion?

Answer 17

1. Insulinoma (insulin secreting tumor) 2. Xylitol toxicity.

Question 18

How can toxins cause hypoglycemia?

Answer 18

Amanita toxicity (type of fungi) can cause liver failure with severe hypoglycemia.

Decreased liver function causes a decrease in glucose

Question 19

What are the six mechanisms of hypoglycemia?

Answer 19

1. Increased insulin secretion 2. Decreased insulin antagonists 3. Decreased gluconeogenesis 4. Increased glucose utilization 5. Toxic/pharmacologic 6. Unknown (sepsis).

Question 20

What is a fructosamine test?

Answer 20

A test that shows the mean glucose concentrations over the last 2-3 weeks.

Question 21

What is a glycosylated hemoglobin (HbA1C) test?

Answer 21

A test that shows the mean glucose concentrations over the last 60+ days.

Question 22

What is exocrine pancreatic insufficiency?

Answer 22

The failure of the exocrine pancreas to produce and secrete digestive enzymes and bicarbonate.

Question 23

What is exocrine pancreatic insufficiency caused by?

Answer 23

Pancreatic acinar atrophy.

Question 24

How can you diagnose exocrine pancreatic insufficiency?

Answer 24

Trypsin-like immunoreactivity (TLI) test.

Question 25

What is the trypsin-like immunoreactivity (TLI) test?

Answer 25

A test that measures the levels of trypsin and trypsinogen in serum.

Question 26

What is amylase?

Answer 26

A pancreatic enzyme that breaks down starch.

Question 27

What is lipase?

Answer 27

A pancreatic enzyme that breaks down fat.

Question 28

What is a differential for mildly elevated amylase and lipase?

Answer 28

Pancreatitis.

Question 29

What is a main differential for marked hypertriglyceridemia but mild hypercholesterolemia?

Answer 29

Pancreatitis.

Question 30

Which liver enzymes will be elevated with pancreatitis and why?

Answer 30

ALT, AST, and ALP, due to reactive hepatopathy.

Question 31

True or False: Elevated amylase and lipase is diagnostic for pancreatitis.

Answer 31

False.

Question 32

How can you diagnose pancreatitis in animals?

Answer 32

1. Canine/feline pancreatic lipase immunoreactivity test 2. Precision PSL.

Question 33

An ______________ PLI supports the diagnosis of pancreatitis.

Answer 33

Increased.

Question 34

Which lipoprotein is the primary one in dogs, cats, and horses?

Answer 34

High density lipoproteins (HDLs).

Question 35

Which lipoproteins are elevated with hypertriglyceridemia?

Answer 35

CMs (chylomicrons) or VLDLs (very low density lipoproteins)

Question 36

Which lipoproteins are elevated with hypercholesterolemia?

Answer 36

LDLs or HDLs (no visible lipemia).

Question 37

Which fat enzymes does insulin stimulate?

Answer 37

Lipoprotein lipase.

Question 38

Which fat enzymes does insulin inhibit?

Answer 38

Hormone-sensitive triglyceride lipase.

Question 39

True or False: Hypotriglyceridemia is not considered clinically significant.

Answer 39

True.

Question 40

Why should patients be fasted before taking blood for hypotriglyceridemia?

Answer 40

Because a non-fasted sample can lead to falsely elevated results.

Question 41

What are four mechanisms of hypocholesteremia?

Answer 41

1. Decreased hepatic function/PSS 2. Protein losing enteropathy 3. Hypoadrenocorticism 4. Neoplasia.

Question 42

What disease should you be concerned about in a horse showing marked hypertriglyceridemia?

Answer 42

Equine hyperlipidemia (EH).

Question 43

What is equine hyperlipidemia (EH)?

Answer 43

A condition common in miniature horses, ponies, and donkeys that enter a negative energy balance.