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SEM 5: SAM 1 > Endocrine 1: Thyroid > Flashcards

Endocrine 1: Thyroid Flashcards

1
Q

The concentration of hormones at target tissue depends on the rate of ____________(3)

A
  1. Rate of production and secretion (feedback loops)
  2. Rate of delivery (rate of blood flow)
  3. Rate of degradation and elimination (dependent on half life)
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2
Q

List the actions of TSH

A
  1. Increased iodide uptake
  2. Increases thyroid peroxidase
  3. Stimulates synthesis of thyroglobulin
  4. Determines rate of endocytosis
  5. Increases the proportion of T3
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3
Q

Thyroid hormones affects what other physiological processes?

A
  1. Development
  2. Growth
  3. Metabolism

(Also effects cardiac, CNS, and repro)

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4
Q

How do thyroid hormones affect metabolism?

A
  • Increases metabolic rate
  • Increases oxygenation and heat production
  • Stimulates fat mobilization/ breakdown of fats
  • Enhances insulin-dependent entry of glucose into cells
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5
Q

How do thyroid hormones affect cardiac function?

A

Necessary for contractility, heart rate, and vascular tone

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6
Q

What is the most common cause of HypoT?

A

Immune mediated lymphocytic thyroiditis

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7
Q

A patient with immune mediated lymphocytic thyroiditis tend to show clinical signs when _____% of the thyroid gland is destroyed

A

75%

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8
Q

What cardiac findings can be present in a patient with HypoT?

A
  • Bradycardia
  • Weak apex beat
  • Decreased contractility
  • Small complexes on ECG
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9
Q

Explain the body temperature in patients with HypoT with HyperT

A

HypoT: low body temp
HyperT: high body temp

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10
Q

What ocular changes can be seen in patients with HypoT?

A
  • Corneal lipidosis
  • Chronic uveitis
  • KCS
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11
Q

List the possible skin changes seen in patients with HypoT

A
  • Bilateral symmetrical, patchy alopecia
  • Rat tail
  • Dry dull hair coat
  • Thick skin
  • Hyperpigmentation
  • Comedones, seborrhea, hyperkeratosis
  • Easily bruised
  • Poor wound healing
  • Myxoedema
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12
Q

What can be seen on CBC, Chem, and UA that can help lead to diagnosis of HypoT?

A
  • Mild normochromic, normocytic anemia
  • Hypercholesterolemia
  • Low T4
  • May be isosthenuric
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13
Q

List causes of low TT4

A
  1. HypoT
  2. Euthyroid sick syndrome
  3. Drugs (glucocorticoids, anti-convulsants)
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14
Q

What is the pathophysiology behind euthyroid sick syndrome causing low T3/T4?

A

When the body is sick it decreases synthesis of T3/T4 to try and preserve body weight and metabolic demand

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15
Q

T4: LOW
T3: LOW
FT4: LOW
TSH: normal

Primary or secondary HypoT?

A

Secondary HypoT - problem @ the pituitary.. not secreting TSH

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16
Q

T4: LOW
T3: LOW
FT4: LOW
TSH: HIGH

Primary or secondary HypoT?

A

Primary HypoT - @ the level of the thyroid gland… can’t respond to TSH

17
Q

What can a thyroid gland biopsy determine?

A
  • Differentiates between lymphocytic vs idiopathic atrophy
  • Used to diagnose neoplasia
18
Q

DOC for treatment of HypoT?

A

Levothyroxine (exogenous T4)

19
Q

Congenital HypoT is more common in _________ (dogs/cats)

A

Cats (rare tho)

20
Q

DOC for treatment of HyperT?

A
  • Methimazole
  • Carbimazole
21
Q

What are some disadvantages to treatment of HyperT with drug therapy?

A
  • Have to have frequent bloodwork rechecks
  • Delayed hypersensitivity in 25% of cats (facial itching, vomiting, liver failure, abnormal blood levels, bleeding)
  • Tumor continues to grow and may become malignant
  • 100% chance of relapse when off meds (life-long drug)
22
Q

How does methimazole work to lower T4 in hyperthyroid patients?

A

Blocks thyroid peroxidase, can’t convert to T3/T4

23
Q

What are some disadvantages to treatment of HyperT with surgical intervention?

A
  • GA risky in cat with compromised CVS
  • May damage the parathyroid gland causing hypocalcemia
  • Requires hospitalization
  • Voice/purr may change
24
Q

What are some disadvantages to treatment of HyperT with I131?

A
  • Requires hospitalization
  • Owner has to collect wastes for 2 weeks due to radiation
  • Owner can’t cuddle cat for 2 weeks bc radiation
  • Irreversible process
25
Q

What are some advantages to treatment of HyperT with I131?

A
  • 95% cure rate
  • Serious side effects are rare
  • Limited testing needed after tx
  • Minimal risk of permanent HypoT
26
Q

Which value can be low on CBC/Chem in some patients post-thyroidectomy?

A

Calcium

(Hypocalcemia post thyroidectomy can occur from damage to the parathyroid gland)

27
Q

A golden retriever presents with bilateral, non-pruritic alopecia and a rat tail. What tests would you want to run?

A

T4 and TSH

to check for HypoT

28
Q

What condition is associated with disproportionate dwarfism in cats?

A

Congenital hypothyroidism

29
Q

True or False: patients with Hypothyroidism usually have pruritic skin

A

False, non pruritic alopecia

SEM 5: SAM 1 (35 decks)

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