Endocrine Flashcards
hich of the following statements regarding canine pituitary macrotumors is true
A) A lot of dogs with pituitary macrotumors show signs of lethargy, mental dullness and decreased appetite
B) A lot of dogs without pituitary macrotumors do not show signs of lethargy, mental dullness and decreased appetite
C) A lot of dogs with pituitary macrotumors show signs of circling, seizures and ataxia
D) A lot of dogs without pituitary macrotumors do not show signs of circling, seizures and ataxia
b
n a study evaluating diagnostic imaging findings in 157 dogs with PDH with and without neurologic signs, central nervous system (CNS)–specific signs such as circling, seizures, and ataxia were neither sensitive nor specific for predicting the presence of a pituitary macrotumor. However, signs such as lethargy, mental dullness, and decreased appetite were highly specific for detection of a pituitary macrotumor but not highly sensitive. Other studies also have documented that mentation and appetite changes are the most common signs associated with pituitary tumors.
Essentially lethargy etc is specific, others are neither specific nor sensitive
Which of these correctly pairs the drug and its mechanism of action in helping patients with Cushing’s disease?
A) Pasireotide - Somatostatin receptor analog
B) Trilostane - Adrenocorticolytic agent
C) Selegiline - Dopamine D2 receptor agonist
D) Bromocriptine – Dopamine degradation inhibition
a
Which of the following treatment survival pairs regarding canine ADH is most accurate?
A) Functional adrenocorticol tumor, surgery, 1 year
B) Nonfunctional aderenocroticol tumor, SRT, 1030 days
C) Functional adrenocorticol tumor, high doses of mitotane, 8 months
D) Functional adrenocorticol tumor, trilostane, 7 months
b
a = 3y
c = 18m
d = 14 m
Cats with insulin resistant DM are often associated with acromegaly. Which factor is responsible for this association?
A) IGF-1
B) IGF-2
C) GH
D) ACTH
c
This insulin resistance is due to a GH-induced postreceptor defect in the action of insulin on target cells.
Which of the following statements regarding surgical management of canine adrenal tumors is TRUE?
A) Peri-operative mortality can range from 50-70%.
B) Bilateral adrenalectomy is possible, but patients will become acutely addisonian after
C) An ultrasound is the recommend imaging of choice pre-operatively, to evaluate surgical planning.
D) Alpha block is contraindicated due to drug interactions in these patients
B. Periop mortality 15-37%. Alpha block is controversial but somewhat recommended
What are the two most commonly documented symptoms in dogs with pituitary tumors?
a. Ataxia
b. Changes in appetite
c. Seizures
d. Changes in mentation
e. Lethargy
b, d
While feline acromegaly results from chronic excessive secretion of GH, and canine/feline pituitary dependent hyperadrenocorticism results from chronic excessive secretion of ACTH, both diseases processes result from a tumor that most commonly arises from which part of the pituitary gland?.
a. Pars tuberalis
b. Pars intermedia
c. Pars distalis
d. Posterior pituitary
e. Hypothalamus
c
Canine adrenocortical adenomas are typically smaller than carcinomas with a cut off of ___cm or more being associated with carcinomas. Furthermore, approximately __% of adrenocortical carcinomas invade into the phrenicoabdominal vein with extension into the renal vein and/ or caudal vena cava.
a. 1cm, 10%
b. 2cm, 20%
c. 3cm, 30%
d. 4cm, 40%
e. 5cm 50%
b
You detect an incidental unilateral adrenal mass on a dog during AUS performed for staging purposes following complete removal of a low grade MCT. When considering whether adrenalectomy vs monitoring would be more appropriate at this point, which of the following criteria would raise the inclination to have an adrenalectomy performed?
a. You suspect the mass is non-functional
b. There is no overt evidence of caval invasion
c. The mass is 1.5cm
d. The mass is 3cm
e. None of the above
D
Adrenalectomy should be considered for masses that are functional, locally invasive, or larger than 2.5 cm in maximum dimension. Masses smaller than 2 cm with no evidence of hormonal activity should be monitored with regular imaging.
Ginny is a 12-year old female spayed Maltese with a chronic history of PUPD, poor skin coat, and panting. Recently she has developed a poor appetite, dull mentation, and seizures. She has a mild elevation in ALP, proteinuria, hypercholesterolemia (like, for real), and her abdominal US is unremarkable apart from a wishy-washy comment about how the radiologist cannot comment on the size of the adrenal glands: “may be a variant of normal”. What is a reasonable treatment for your primary suspicion?
A) Hypophysectomy
B) Trilostane
C) Conventional RT +/- Trilostane
D) Selegeline
c
Minerva is a 12yo FS DSH that has become PUPD, and weight loss despite a voracious appetite. While shaving to better visualize a vein, Minerva develops a large tear in her skin with significant bruising. What is your suspicion?
A) Your technician needs to stop hulking out when collecting blood
B) PUPD is secondary to liver failure, bruising secondary to coagulation factor deficiency
C) Hemorrhage secondary to the effects of a pheochromocytoma
D) Delicate skin associated with feline Cushing’s syndrome
d
After some kind of stroke you take a job in the internal medicine department. You have been managing Dursley (5yo MN DSH) for several months for Diabetes Mellitus. His management has been difficult and he currently requires 12 units of Insulin per day. His owners have noted difficulty walking and bilateral hind limb lameness. Which of the following is NOT a prominent differential for his hind end issue?
A) Maybe Dursely also had some kind of stroke (incomplete aortic thromboembolism)
B) Diabetic peripheral neuropathy
C) Acromegaly associated arthropathy
D) All the arthritis
d
Tonks is a 10yo apparently neutered male cat that has recently been showing signs of aggression to other cats and has started urine marking. You note a barbed penis on PE an elect to perform an AUS. A right sided adrenal mass is noted, what do you recommend?
A) Abdominal/ thoracic CT and adrenalectomy or SRT
B) Exploratory laparotomy for retained testes
C) Medical management with Spironolcatone
D) Benign neglect, adrenocortical tumors in cats are usually benign. Maybe Tonks is just a bit of an asshole
a
relawney is a 9yo FS Lab X presenting to the ER for collapse episodes. You appreciate tachycardia, hypertension, and a vascular retroperitoneal mass on AFAST (no other abnormalities on AFAST/ TFAST). Which of the following could be a helpful diagnostic?
A) Urine normetanephrine
B) FNA that thing, what could possibly go wrong
C) Low dose dexamethasone suppression test
D) ACTH Stim
a
what’s the typical signalment for thyroid neoplasia in the dog?
- medium to large breed
- 10-15yo
- Golden, Husky, Beagle
