Clin Path Final - Kumthekar TS Flashcards
What lipids are responsible for lipemia (haziness in serum)?
high triglycerides and VLDL (not high cholesterol)
What is the term for increase in circulating lipids, increased triglycerides and/or increased cholesterol?
hyperlipidemia
When does psysiological hyperlipidemia reach its peak?
4-6 hours after eating
What breeds are subject to idiopathic primary hyperlipidemia?
schnauzers and beagles
What hereditary disease in cats is a defect in lipoprotein lipase causing primary hyperlipidemia?
idiopathic hyperchylomicronemia
What are the most common causes of secondary hyperlipidemia in dogs and cats?
endocrine disorders - DM, hypothyroid, hyperadrenocorticocism
What kind of horses get irreversible metabolic disorders from hyperlipidemia?
small fat ponies
What are the clinical findings in small fat ponies with hyperlipidemia?
blood turbid
high GGT, AST, Gld, BA
blood cholesterol and triglycerides high
fatty infilatration of liver
What are the routine lab findings of fatty liver dz in cattle?
raised liver enzymes and BA
ketonemia, ketonuria,
low albumin, Mg
high FFA and triglycerides
What are the 3 ketone bodies?
acetone, acetoacetic acid and B hydroxybutyric acid (BHB)
What can cause primary ketosis in sheep and cattle?
sheep - twins
cattle - complication of fatty liver
When diseases cause secondary ketoses?
any other dz causing anorexia and hypoglycemia
What are the lab findings in ketosis?
ketonuria, excess BHB in blood, hypoglycemia
In which species does ketosis usually accompany hyperglycemia?
cats and dogs with DM
How can you differentiate transient hyperglycemia from endocrine associated hyperglycemia?
transient will have no glucosuria
What other disorders besides diabetes will cause a hyperglycemia?
cushings, acromegaly, hyperthyroidism, pituatary dysfunction in horses, pheochromocytoma and milk fever in cattle
What can cause hyperglycemia besides endocrine and transient causes?
enterotoxemia in sheep
Which neoplasm will cause a hypoglycemia?
insulinoma
Does endotoxemic sepsis cause hypo or hyperglycemia?
hypo
What are the 3 routine lab findings in DM?
hyperglycemia, glycosuria, ketonuria
What does hyperglycemia during diabetes mellitus need to be differentiated from?
primary renal glycosuria - fanconis syndrome
What test is done for latent/equivocal cases for diabetes mellitus?
glucose tolerance test
What are the outcomes of the glucose tolerance test for a healthy dog? diabetic dog?
healthy - glucose doubles at 2 hours, recedes at 5 hours
diabetic - glucose peak higher, remains above baseline
What test indicated glucose control over prior 3-4 weeks in dog and cat?
serum fructosamine
What test indicates glucose control over 6-8 weeks in dog and cat?
serum glycosylated Hb
What species get insulinomas?
dogs and ferrets
What test is used for insulinomas besides hypoglycemia?
insulin to glucose ratio
What is the primary cause of cushings disease in dogs?
pituatary based (80%)
What are 2 screening tests for cushings dz? What can give a false positive result in both?
Alkaline phosphatase isoenzyme heat resistance
urine cortisol/creatinine ratio
false positive - stress
What are 2 diagnostic tests for cushings disease?
Low dose dexamethasone suppression test
ACTH stimulation test
What are the normal and cushings results for low does dexamethasone suppression test?
normal - basal cortisol varies (suppressed)
cushings - basal cortisol high (not suppressed)
What test also monitors cushings, detects iatrogenic cushings, and diagnoses addisons disease?
ACTH stimulation test
What test will determine if a dog has pituatary based cushings if the result is suppression?
high dose dexamethasone suppression
What characterizes addison’s crisis?
bradycardia, CV collapse, shock, dehydration
What are the 2 most important routine lab findings in addisons disease?
high blood K
low blood Na
Na/K ratio = <15/1
What is the definitive test for hypoadrenocorticocism?
ACTH stimulation (pre and post cortisol is low)
What are the routine lab findings for diabetes insipidus?
consistently very low urine SG (1.001-1.006)
What test differentiates between nephrogenic and central diabetes insipidus?
water deprivation/vasopressin test
What are routine clinical findings in dogs with hypothyroidism?
hyperlipidemia, cholesterol, non regen anemia
possible raised AP and CPK
Which test has good specificity for hypothyroid?
total T4
What else should be tested if a dog has low T4?
measure antibodies to T4, T3
increased serum TSH adds specificity
decreased fT4 highly specific
What is the best ratio to measure for hypothyroid?
fT4/TSH ratio (instead of tT4/TSH)
What semi-diagnostic test is used for hypothyroid?
TRH or TSH stimulation (give hormone, no increase -> hypothyroid)
How can you differentiate between lymphocytic thyroiditis and thyroid atrophy in a hypothyroid dog?
positive TgAA test indicates lymphocytic thyroidits
What other diseases MUST be considered for a dog with low tT4?
hyper/hypoadrenocorticocism, severe pyoderma, DM, chronic renal failure, liver dz
What causes hypothyroidism in large animals?
iodine deficiency or deficiency 2ry to goitrogens (brassica)
horses-very unusual
What are the clinical signs of cattle with hypothyroidism?
neonates - stillborn, weak, goitrous, edematous
What are the CS of horses with hypothyroid?
obesity and musculoskeletal dz
How is hypothyroid diagnosed in large animals?
blood lvls of inorganic iodines or tT4 of a representative group
What is a common histo finding of feline hyperthyroidism?
adenomatous hyperplasia
What are the routine lab findings of a hyperthyroid cat?
ALT + ALP - mild increases
erythrocytosis, leukocytosis
Raised Urea + Creatinine (age related)
What can be used to confirm equivocal cases of feline hyperthyroid?
T3 suppression test
When can primary hypoparathyroidism occur in dogs? cats?
dogs - rare - autoimmune, neoplasia
cats - iatrogenic
What are the lab findings in hypoparathyroidism? How is it diagnosed?
hypocalcemia, hyperphosphotemia
measure PTH levels (frozen)
What are examples of functional hypoparathyroidism?
common - milk fever, eclampsia
How can you diagnose fxnal hypoparathyroidism?
very low blood Ca and often mild low PO4 or Mg
What is the most common 2ry hyperparathyroidism? How is it diagnosed?
renal - inable to excrete phosphorus high PTH (Ca + P not diagnostic)
What should not be used when taking samples for calcium analysis?
EDTA or binders (citrate)
What protein can cause fluctuations in total calcium without influencing ionized calcium?
albumin (50% of Ca is bound to it)
What chemistry factor affects free calcium?
pH (acidosis = increased free calcium)
What is the most common cause of hypercalcemia in small animals?
humoral hypercalcemia of malignancy
What is the most common cause of hypocalcemia in dogs?
hypoalbuminemia
What can cause hypocalcemia in both dogs and cats?
acute pancreatitis, primary hypoparathyroidism,
What is the most common cause of hyperphosphatemia in dogs and cats?
renal dz
What is the most important cause of hypophosphatemia in cattle?
post parturient hemoglobinuria
Why is hypomagnesium often associated with hypocalcemia?
Mg prevents PTH release
What causes hypomagnesia in ruminants?
dietary deficiency - grass tetany, fertilizers
What are the causes of hypomagnesia in small animals?
renal loss (most common), diarrhea, grass tetany
What are the clinical signs and findings with hypomagnesia?
concurrent hypocalcemia, blood and urine have low Mg
What is the most important cause of hypermagnesia?
decreased urinary excretion (renal failure)
others - hemolysis, absorption, milk fever
