Endocrine

Question 1

What is an adipokine? Name some examples?

Answer 1

Protein or hormone secreted from adipose cells

Ex: TNF alpha, leptin, adiponectin

Question 2

How does leptin work?

Answer 2

Inhibits neurotransmitters that increase appetite and slow metabolism and stimulates neurons that decrease appetite and increase energy expenditure

Promotes weight loss

Question 3

How does adiponectin work?

Answer 3

Most abundantly secreted adipokine in circulation
Lower levels w increased fat mass
Closely associated w insulin sensitivity
Low levels of adiponectin associated with chronic inflammatory states like obesity, insulin resistance, type 2 DM, cardiovascular disease

Question 4

What is role of TNF-alpha in obesity?

Answer 4

This is a cytokines secreted by lots of cells including adipocytes

Obesity increases macrophage migration into adipose tissue, causing increased TNF alpha expression in overweight individuals

This causes local insulin resistance. It also decreases uptake of FFA into adipocytes and promoted lipolysis and release of FFA into circulation. FFA levels increase in circulation and negatively impact insulin sensitivity

Question 5

MOA of slentrol (dirlotapide) and mitratapide (Yarvitan)?

Answer 5

Microsomal transport protein inhibition at intestines. Means that lipids don’t get assembled into apoprotein B, which means they don’t get absorbed
More importantly, the increased lipid causes secretion of satiety signals from gut (like pancreatic peptide Y, PYY) and inhibition of voluntary food intake

Question 6

Examples of human weight loss drugs?

Answer 6

Sibutramine (Meridia)- inhibit serotonin and NE reuptake

Oralistat (Xenical)- increases fecal fat excretion

Phenteramine (Adipex-P)- increases metabolism similar to speed

Question 7

What breeds are predisposed to hyperlipidemia?

Answer 7

HTG- schnauzer, beagle

HCH- Shelties, Dobies, Rotties, Briards, rough-coated collie, Pyrenees

Question 8

What are some uncommon causes of hyperlipidemia?

Answer 8

Phenobarbital therapy, parvo, hypernatremia (maybe), Leishmania, lymphoma, hepatic insufficiency

Question 9

How do omega 3 FA work to treat hyperlipidemia

Answer 9

Increased beta oxidation, reduced lipogenesis, and activation of LPL

Question 10

MOA of niacin?

Answer 10

Not super known but inhibits hormone sensitive lipase and inhibits diacylglycerol acetyltransferase= reduced triglyceride synthesis

Question 11

What side effects known for niacin in dogs? W

Answer 11

Myotoxicity maybe hepatotoxicty. Also erythema and pruritus

Question 12

How does gemfibrozil work?

Answer 12

This is a fibric acid derivative. It inhibits peroxisome proliferator activated receptor alpha. This is a transcription factor that regulates lipid and lipoprotein synthesis and catabolism

Essentially it does a bunch of things that result in decreased triglyceride levels

Question 13

Why no use statins in dogs?

Answer 13

Bc they’ll work on cholesterol not triglyceride

Also when used with fibrates there is an increased risk of hepatotoxicty

Question 14

Which breed predisposed to primary hyperparathyroidism?

Answer 14

keeshonds

Question 15

Do dogs with primary hyperthyroidism develop CKD bc of hypercalcemia?

Answer 15

NO! For some reason these dogs seem protected from renal failure

Question 16

What are common co-morbidities of primary hyperparathyroidism?

Answer 16

UTI-30%

Cystic calculi- 30%

Question 17

You have a patient w normal PTH and high calcium. What’s the diagnosis?

Answer 17

Primary hyperparathyroidism

As calcium levels rise PTH should become undetectable

Question 18

When do you do pretreatment w calcitriol for PHP?

Answer 18

When total calcium greater than 15 or more than one parathyroid mass. They have a higher risk of post procedure hypocalcemia

Question 19

What sort of tumor causes primary hyperparathyroidism?

Answer 19

Histologically classified as adenoma, hyperplasia, or carcinoma. Doesn’t matter bc they don’t met or invade and recurrence is 10% regardless of tumor type

Question 20

What is desmopressin?

Answer 20

Synthetic analog of natural anti-diuretic hormone. Has increased ADH activity and prolonged duration of action, decreased pressor actions, fewer side effects than natural hormone.

Question 21

What route of admin is best for desmopressin?

Answer 21

Maybe SC bc can give smaller amts more efficaciously and it lasts longer but you can do oral and conjunctival as well.

Question 22

When do you consider doing a desmopressin response test?

Answer 22

When you’ve limited Ddx to central DI, nephrogenic DI or primary polydipsia

Question 23

What results on desmopressin response test tell you it’s central DI?

Answer 23

> 50% reduction of water intake and polyuria strongly suggest diagnosis of central DI. But lack of any reduction in PU/PD is probably due to nephrogenic DI.

Question 24

What are adverse effects of desmopressin?

Answer 24

Fluid retention, hyponatremia, decreased plasma osmolality. Water intoxication rarely can cause CNS disturbances. Give furosemide if it happens

Question 25

Who gets diabetic nephropathy?

Answer 25

Cats more commonly than dogs. Usually proteinuria and hypertension are the manifestations and azotemia is a late consequence

Don’t see it that much in dogs bc they don’t live long enough

Question 26

What is the mechanism of diabetic neuropathy?

Answer 26

Polyol pathway via aldose reductase promotes formation of sorbitol from glucose and then to fructose via sorbate dehydrogenase. Fructose accumulates in the nerves of cats and results in accumulation of glycation end products

Demyelination and splitting and ballooning of myelin are common in these cats

Question 27

Why don’t cats get diabetic cataracts?

Answer 27

Less aldose reductase activity in the lens. Maybe that’s the cause

Question 28

Which is the primary ketone in dogs and cats?

Answer 28

Beta hydroxybutryrate. Also, it’s not measured on urine dipstick!

Question 29

Definition of obesity

Answer 29

Exceeding ideal body weight by 15-20%

Question 30

What’s the pathogenesis of megaesophagus and decreased thyroid?

Answer 30

Unknown! May or may not recover fxn too

Question 31

What’s mechanism of peripheral neuropathy w hypoT4?

Answer 31

Usually metabolic. Maybe consequence of impaired axial transport

If they have vestibular dz, it could be due to compression of facial and vestibular n as they cross internal acoustic meatus (unknown why)