Tests For Endocrine Disease Flashcards Preview

Small Animal Endocrinology > Tests For Endocrine Disease > Flashcards

Flashcards in Tests For Endocrine Disease Deck (26):
1

What is the best screening test for Cushings?

Low dose dexamethasone suppression test

2

How can you differentiate between pituitary dependent and adrenal dependent hyperadrenocorticism with the dexamethasone suppression test?

Pituitary dependent - ACTH will not be suppressed

Adrenal dependent - ACT will be suppressed

3

What test can be used to monitor treatment for hyperadrenocorticism?

ACTH stimulation test

4

What is the best test to rule out hyperadrenocorticism in a work up of PU/PD?

Urine cortisol creatinine ratio

5

What test is best for determining the origin of the disease?

ACTH assay
- ACTH high - pituitary mediated
- ACTH low - adrenal mediated

6

When should you perform a high dose dexamethasone suppression test?

When you suspect an adrenal tumour

7

How can you differentiate between primary, atypical and secondary addisons?

Primary - low cortisol, high ACTH, electrolyte abnormalities
Atypical - low cortisol but normal electrolytes
Secondary - low ACTH, low cortisol, electrolyte abnormalities

8

How can you diagnose Addisons?

A single cortisol measurement
- below 55

9

What are the common clinical signs of diabetes mellitus?

PU PD
Polyphagia
Weight loss

10

What haematological / biochemical / urinalysis abnormalities will you see in diabetes mellitus?

Hyperglycaemia
Increased ALP ALT
Hypetriglyceridaemia l

Ketonuria
Glucosuria
Active sediment
Low USG

11

How can you diagnose diabetes mellitus?

Clinical signs
Persistent fasting hyperglycaemia
Glucosuria

12

How does diabetic ketoacidosis present?

Vomiting
Depression
Dehydration
Weakness
Tachypnoea

13

How can you diagnose diabetic ketoacidosis?

Ketonuria
Azotaemia
Acidosis

14

What electrolytes are lost in the urine due to acidosis in ketoacidosis?

K+ and phosphate
Supplement with fluid therapy

15

How can you diagnose canine hypothyroidism?

Low total T4 = definitive
Ddx sick euthyroid syndrome
- differentiate using free T4 - free T4 will be normal in dogs with sick euthyroid syndrome
- can also use a TSH assay - TSH will be high in hypothyroid dogs

Low T4 and high TSH = diagnosis of hypothyroidism

TgAAs
Thyroid function tests

16

What abnormalities will you see on the essential database in hyperthyroidism?

Mild to moderate erythrocytosis and macrocytosis
Heinz bodies
Leukocytosis
Increased ALP, ALT, AST
Azotaemia
Hyperkalaemia
Reduce fructosamine

17

What common endocrinopathy is seen in combination with feline hyperthyroidism?

Diabetes mellitus

18

What gives you the most definitive diagnosis of feline hyperthyroidism?

Total T4 elevated

19

What test is more sensitive in diagnosing early feline hyperthyroidism?

Free T4

20

What is central DI?

Brain does not release ADH

21

What is primary DI?

Kidney doesn't respond to ADH

22

What is secondary DI?

Kidney doesn't respond to ADH due to other disease
- renal failure, hyperadrenocorticism, pyo, hypercalcaemia, hyperthyroidism, pyelonephritis, hypoadrenocorticism, liver failure, hypokalaemia, acromegaly

23

How can you define polydypsia?

Drinking more than 100 ml/kg/day

24

How can you work up PU/PD?

History - rule out iatrogenic - drugs
Physical - pyo/ renal diseas
Haematology - pyo / pyelonephritis
Biochemistry-hypercalcaemia, hyponatraemia, renal disease, diabetes
Bile acids - liver disease
Total T4 - hyperthyroidism
Urinalysis - diabetes, fanconis, renal glucosuria
Urine creatinine cortisol ratio - hyperadrenocorticism
Water deprivation test - last step
Response to exogenous ADH (central DI)

25

How does acromegaly usually present?

Cats - pituitary tumour - middle aged male cats

Bitches in the luteal phase

26

What are the clinical features of acromegaly?

Insulin resistant diabetes mellitus
Excessive growth of the extremities
Wide interdental spaces
Soft tissue proliferation

Elevated liver enzymes
Elevated IGF1
MRI - pituitary mass