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Clinical Pathology Exam 4 > Lecture 3 > Flashcards

Lecture 3 Flashcards

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1
Q

Who does hypothyroidism occur most commonly in?

A

Dogs

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2
Q

What causes hypothyroidism?

A

Immune mediated/ idiopathic

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3
Q

What are some clinical signs of hypothyroidism?

A 
Lethargy
Inactivity
Dullness
Weight gain without increased appetite
Alopecia/dull hair coat
Seborrhea
Cold intolerance
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4
Q

Hypothyroid CBC

A

+/- mild nonregenerative anemia
+/- codocytes

Overall boring

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5
Q

Hypothyroid chemistry

A

Hypercholesterolemia
Hypertriglyceridemia
Accumulation of plasma lipids

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6
Q

What causes hyperthyroidism? Who does it occur in?

A

Hyperplasia or adenoma of thyroid in cats

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7
Q

Clinical signs of hyperthyroidism

A 
Weight loss
Polyphagia
PU/PD
Restlessness
GI/vomiting
Skin changes
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8
Q

Common PE finding of hyperthyroidism

A

Palpable thyroid

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9
Q

Hyperthyroid CBC

A

May be normal RBCs or mild increase in PCV
Heinz bodies
May have stress or physiologic leukogram

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10
Q

Hyperthyroid chemistry

A

Mild increase in ALT and/or ALP

Azotemia (BUN, creatinine, Phos)

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11
Q

If you see moderate/marked increase in ALT and/or ALP in a hyperthyroid cat, what should you do?

A

Look for concurrent disease

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12
Q

What diseases are on your list with weight loss despite good appetite

A 
Hyperthyroidism
Diabetes
GI disease
Malabsorption
Maldigestion
Cushings
Poor diet
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13
Q

What causes increased ALT and ALP in hyperthyroidism

A

Hepatic hypoxia because increased oxygen utilization (ALT)

ALP may be from bone isoform or cholestasis

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14
Q

What causes azotemia in hyperthyroid cats

A

Concurrent kidney disease!

Uncomplicated hyperthyroidism should increase renal blood flow and GFR

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15
Q

Hyperthyroidism UA

A

Proteinuria

Subclinical UTI

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16
Q

What does zona glomerulosa do

A

Mineralocorticoids (aldosterone)

“Salt”

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17
Q

What does zona fasiculata do

A

Glucocorticoids (cortisol)

“Sugar”

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18
Q

What does zona reticularis do

A

Androgens (sex steroids)

“Sex”

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19
Q

What does medulla do?

A

Catecholamines (epi, norepi, dopamine)

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20
Q

What is hyperadrenocorticism?

A

Canine cushings disease

Overproduction of cortisol from pituitary neoplasm or adrenal cortex neoplasm

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21
Q

Cushing CBC

A

RBCs may be normal or may have mild increase in PCV
Stress leukogram and hyper-segmented neutrophils
+/- thrombocytosis

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22
Q

Cushings chemistry

A 
Increased ALP (dogs only- steroids)
Increased ALT
Increased cholesterol
Increased glucose
Decreased BUN
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23
Q

Cushings UA

A

Proteinuria
silent UTI
Dilute urine (because of ADH interference)

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24
Q

What is hypoadrenocorticism

A

Addisons disease
Destruction of adrenal cortex from immune mediated or idiopathic
Low cortico- and mineralocorticoids

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25
Addisons CBC
RBCs may be normal or anemic May have increased PCV from dehydration Lack of stress leukogram “relaxed leukogram”
26
Addisons chemistry
``` Azotemia Low Na Low Cl High K Decreased Na:K ratio Low glucose Low cholesterol High Ca Increase in liver enzymes Metabolic acidosis Low albumin ```
27
Addisons UA
Not fully concentrated urine despite being dehydrated (don’t confuse for renal failure)
28
What is atypical addisons
When an addisonian lacks electrolyte abnormalities
29
What is hyperaldosteronism and who does it affect
Adrenal cortical neoplasia/hyperplasia in older cats
30
What are clinical signs of hyperaldosteronism
Hypokalemia that causes polymyopathy and PU/PD | Hypertension (ocular manifestations)
31
What is adrenal disease in ferrets
Adrenocortical hyperplasia/neoplasia | Secretes androgens/estrogens
32
Ferret adrenal disease clin path findings
Often normal or may have anemia/pancytopenia due to estrogen toxicity Urethral obstruction may be present causing azotemia, hyperkalemia, or low Na and Cl if there is a urinary rupture
33
What is equine cushings
Pars intermedia dysfunction (PPID) | Occurs in aged horses and ponies
34
Clinical signs of PPID
``` Hirsutism Laminitis PU/PD Weight loss Increased sweating Abnormal fat distribution ```
35
PPID clin path findings
CBC: anemia, stress leukogram Chem: hyperglycemia, hypertriglyceridemia UA: glucosuria Or all could be normal
36
What is acromegaly and who does it affect
``` Older cats (male disposition) Pituitary ademona which secretes GH ```
37
What does growth hormone do
Secretes IGF1 | Insulin antagonist
38
Acromegaly clin path findings
Weight gain and poor glycemic control | Often hyperproteinemic
39
What is the most common disease of the endocrine pancreas
Diabetes mellitus
40
What are classic signs of diabetes mellitus
PU/PD Polyphagia Weight loss
41
Diabetes mellitus CBC
Normal in uncomplicated diabetic | Shouldnt see inflammatory leukogram unless there is concurrent disease
42
Diabetes mellitus chemistry
Hyperglycemia Hypercholesterolemia Increased ALP and ALT (MILD) Unpredictable electrolytes and minerals
43
If you have diabetes and marked ALP/ALT, what should you think about?
Diabetes plus hyperadrenocorticism
44
Diabetes UA
Glucosuria Inappropriate concentration +/- ketonuria +/_ UTI, proteinuria, bacteriuria, WBC, RBC
45
What is diabetic ketoacidosis
Occurs in diabetes complicated with other disease | Increased ketones because fats are being mobilized for energy
46
What do ketones cause?
Contribute to acidosis (high anion gap) | Worsen osmotic diuresis and electrolyte depletion
47
What could it be when you have unconcentrated urine and azotemia but NOT renal diseasen
Central diabetes insipidus (less ADH production) Inhibition of ADH (high calcium, high cortisol, low sodium, low potassium) Medullary washout (liver failure, Addisons) Osmotic diuresis (diabetes mellitus)
48
What does hypotriglyceridemia mean?
Nothing!
49
Causes of hypertriglyceridemia
``` Post prandial Diabetes mellitus Glucocorticoid (cushings, iatrogenic) Hypothyroidism Pancreatitis Breed related NEB/dyslipidemias ```
50
Causes of hypercholesterolemia
``` Post prandial (mild) Diabetes mellitus Cushings Hypothyroidism Cholestasis Pancreatitis Breed related Nephrotic syndrome ```
51
Causes of hypocholesterolemia
Malabsorption/maldigestion Decreased liver function or failure i.e. PSS Addisons Neoplasia
52
What diseases mobilize fat for energy?
Diabetes mellitus | NEB
53
What ketones are produced from lipid metabolism
Acetone Acetoacetate BHB
54
What are presence of ketones called in bovine and camelids?
Ketosis
55
What are presence of ketones called in small ruminants
Pregnancy toxemia
56
What are presence of ketones called in dog/cat
Ketoacidosis
57
What species do not synthesis ketones
Horses
58
When do non-esterified fatty acids increase?
Negative energy balance | Used mostly in cattle and camelids
59
When cows are in NEB, what do they NOT have
Increased triglycerides and lipemia
60
What is dyslipidemia
Disorder of lipid metabolism associated with abnormal amounts of circulating lipids
61
What is hyperlipidemia
Blood does not appear lipemic | Can occur in any equid (trigs usually less than 500)
62
What is hyperlipemia
Blood appears lipemic and trigs greater than 500 | Occurs in donkeys, minis, and ponies
63
What causes equine dyslipidemias
Insulin resistance causes NEB
64
What are some causes of equine insulin resistance
Age, diet, anorexia, endocrine disease, obesity, inflammatory conditions
65
What are predisposing factors of equine hyperlipidemia
NEB, insulin resistance, azotemia *no fatty infiltration of organs
66
What are predisposing factors of equine hyperlipemia
NEB, insulin resistance Ponies- stress, weight loss, pregnancy/ weight loss Mins/donkeys- underlying chronic illness Causes fatty infiltration of organs and has a poor prognosis!
67
``` What do horses release in NEB? Camelids? Sheep/goats? Cattle? Dog/cat? ```
``` Horses- trigs Camelids- trigs and ketones Sheep/goat- ketones Cattle- NEFA Dog/cat- ketones ```
68
What is equine metabolic syndrome
Syndrome characterized by obesity, regional adiposity, insulin resistance, laminitis May or may not have hyperglycemia and hypertriglyceridemia
69
What are signs if an addisonian crisis
Hypovolemic/dehydrated | Bradycardic

Clinical Pathology Exam 4 (4 decks)

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