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MOD Exam 3 (part 2) > Endocrine > Flashcards

Endocrine Flashcards

1
Q

All of the following are effects of cortisol EXCEPT:

A. Increase blood glucose level
B. Increase gluconeogenesis
C. Decrease protein stores in liver cells
D. Decrease protein stores in somatic cells
E. Mobilize fat from storage.
F. Released from the zona fasciculata and reticularis of the adrenal cortex.

A

C.
Cortisol decreases protein storage in cells OTHER than liver cells…it increases synthesis of liver proteins and plasma proteins.

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2
Q

T or F:

Both production and catabolism of cortisol are increased when thyroid hormones are high.

A

True

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3
Q

T or F: Aldosterone secretion is directly controlled by potassium concentration, sodium concentration and Angiotensin II.

A

False

Just K and Angiotensin II

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4
Q

T or F:

An excess of Growth Hormone is found concurrently with 1/5 to 1/4 of all cats diagnosed with diabetes mellitis.

A

True

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5
Q

Which of the following is NOT released when blood glucose levels drop?

A. Glucagon
B. Growth Hormone
C. Cortisol
D. Insulin
E. B and D only
A

D. Insulin

Insulin is released when BG goes UP- remember, insulin wants to get glucose into cells to be used.

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6
Q

Choose the CORRECT pairing of endocrine pancreas cells and their associated hormones:

A. Alpha cells: Insulin, glucagon
B. Beta cells: Insulin, amylin
C. Delta cells: somatomedin
D. Beta cells: Insulin only

A

B. Beta cells secrete insulin and amylin

Delta cells secrete somatoSTATIN; somatomedin is insulin-like growth factor, produced by liver.

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7
Q

Which of the following is NOT a cause of insulin resistance?

A. Glucagonoma
B. Chronic corticosteroid administration
C. Acromegaly
D. Obesity
E. Infection
F. Insulinoma
A

F.

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8
Q

Which of the following is NOT associated with primary hyperparathyroidism?

A. Usually due to bilateral benign functional adenoma
B. Young dogs, especially Keeshounds, tend to get it more often than other groups.
C. You will see a hypercalcemia, hypophosphatemia, and elevated PTH levels.
D. The most common presenting problem is urolithiasis
E. There is no sex predisposition.

A

B.

It is OLDER dogs that get primary hyperparathyroidism. Keeshounds ARE predisposed, as well as poodles, retievers and GSDs.

Most common presenting complaint is pu//pd, but the clinical issue is urocystolithiasis.

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9
Q

T or F:

Unlike in primary hyperparathyroidism, secondary hyperparathyroidism is characterized by normocalcemia or hypocalcemia.

A

True

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10
Q

T or F:

Primary hypoparathyroidism typically affects middle-aged small breed male dogs.

A

False

Female dogs (toy poodles, mini schnauzers, terriers)

Remember, middle aged ladies need to take their calcium supplements!

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11
Q

T or F:

A fungal granuloma on the adrenal cortex could cause a secondary form of Addison’s Disease.

A

False!

Yes, it could cause an acquired form of Addison’s, but this would still be considered primary because it is affecting the adrenal tissue as opposed to the pituitary.

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12
Q

You have a dog who you are suspecting has an insulinoma who has severe hypoglycemia and fits the signalment. However, the serum insulin level is within the reference range. What do you conclude?

A. The dog has an insulinoma.
B. The dog has diabetes mellitus
C. There must be something wrong with the test- the results don’t fit the clinical picture.
D. Look for other causes of hypoglycemia.

A

A.

Although it is within the reference range, in this case it is inappropriate to be releasing insulin at all with BGs that are very low. The serum insulin should be 0 with a normal dog, or a dog that is suffering from hypoglycemia from other causes.

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13
Q

T or F:

Liver and/or kidney disease can result in hypergastrinemia.

A

True

The liver and kidney each metabolize or excrete about 50% of the gastrin, and if there is a disease of either one of these organs the gastrin levels will rise.

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14
Q

Trimethoprim Sulfa (TMS) administration in a growing puppy could result in the following

A. Damage to cartilaginous structures
B. Hypothyroidism and goiter
C. Bone marrow suppression
D. Yellowing of the teeth

A

B.

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15
Q

Primary congenital hypothyroidism is described in _________ (dog breed), whereas secondary congenital hypothyroidism is descibed in ____________ (dog breed).

A

primary- toy fox terriers

secondary- giant schnauzers

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16
Q

Which breed of dog is predisposed to having panhypopituitarianism (Pituitary dwarfism/Proportional Dwarfism)?

A. Giant Schnauzer
B. Labrador Retrievers
C. German shepherds
D. Beagles
E. Standard poodles
A

C

17
Q

Primary hypothyroidism associated with antithyroglobin Antibody (lymphocytic thyroiditis) is most common in the following breeds:

A. Labradors, Goldens
B. Beagles and Borzois
C. Rhodesian Ridgebacks, English setters and dobermans
D. Giant schnauzers and toy fox terriers

A

C

18
Q

You have just diagnosed Cushing’s disease in your canine patients and now want tto differentiate whether it is primary (from the adrenals) or secondary (PDH). You do an ultrasound and find that the left adrenal gland is enlarged and the right is smaller than normal. What do you conclude?

A. The patient has primary Cushing’s
B. The patient has secondary Cushing’s
C. More tests are needed.

A

A.

If it were secondary, they would both be enlarged.

U/S is now regarded as the best way to differentiate primary from secondary Cushings.

19
Q

T or F:

The less common adrenal-dependent form of Cushing’s disease tends to be seen in larger breed dogs.

A

True

20
Q

Which of the following can be a cause of secondary (acquired) nephrogenic diabetes insipidus?

A. Hyperadrenocorticism
B. Hypoadrenocorticism
C. Hypercalcemia
D. Renal medullary washout
E. Pyometra
F. All of the above can cause it
A

F.

21
Q

T or F:

Myotonia is a sign that is associated with some pituitary tumors in Cushings disease, whereas neurological issues tend to be caused by the adrenal tumors that cause Cushings.

A

False!

Myotonia- Adrenal
Neurological- pituitary

22
Q

T or F:

Before doing an adrenal surgery to remove an adenoma in a Cushing’s animal, you want to be sure to do a clotting profile, as these dogs tend to suffer from hemorrhagic diatheses (tendency to bleed).

A

False!!!

They tend to CLOT!!! You want to treat them with fractionated low-dose HEPARIN before surgery!!

23
Q

Which 3 breeds of dog did she highlight in class that are predisposed to Addison’s disease, and what age group does it affect?

A

Standard Poodle, Rottweiler and Portuguese Water Dog

Young to middle aged!!! (Tend to be more females)

24
Q

T or F:

Polyendocrinopathies are common to see with Addison’s disease, with dogs having hypothyroidism or Diabetes mellitis type I in addition to the Addison’s.

A

True!

Because primary Addison’s is usually caused by immune mediated destruction of the adrenal cortical layers, and often the immune system is also destroying thyroid and pancreatic tissue as well.

25
Q

A possible complication to treating a patient surgically for a pheochromocytoma might be

A. Iatrogenic Cushing’s
B. Iatrogenic Addison’s
C. Iatrogenic Hypothyroidism
D. Pituitary and Hypothalamic atrophy

A

B

26
Q

T or F:

Atypical Addison’s can develop into typical Addison’s disease.

A

True!

Because destruction of the layers of the adrenal cortex go starting from inside and go out (Zona reticularis to Zona glomerulosa).

27
Q

T or F:

Because of the effect of glucocorticoids on vascular tone, Addison’s patients often present with profound hypotension.

A

True.

In addition to alpha and beta adrenergic effect, glucocorticoids affect vascular tone and thus total peripheral resistance, and typical Addisons patients are lacking in glucocorticoids (also, they are extremely dehydrated from loss).

28
Q

What is the most emergent issue in the acute Addisonian crisis?

A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypotension
E. Hypoglycemia
A

A.

29
Q

Hepatocutaneous syndrome is associated with which of the following?

A. Insulinoma
B. Glucagonoma
C. Diabetes mellitis
D. Addison's Disease
E. Cushing's Disease
F. B and C.
A

F

30
Q

T or F:

The pathogenesis of type II Diabetes mellitus involves the release of amylin simultaneously with insulin and its toxic effect on the pancreatic islet cells in large amounts over time.

A

True.

31
Q

Which of the following can cause peripheral resistance to insulin?

A. obesity
B. Autoantibodies
C. Glucose toxicity
D. Growth hormone
E. Cortisol
F. Progesterone
G. All of the above
A

G

32
Q

Why spay a pregnant bitch if she is diabetic?

A

Bc progesterone worsens peripheral insulin resistance.

33
Q

T or F:

Insulinoma tends to be seen in small breeds of dogs.

A

False! Large and giant breeds

34
Q

An older golden retriever comes into your clinic for a wellness check and the owner complains that she is suffering from exercise intolerance. You take blood and find that she has a BG of 25 mg/dL (the blood was NOT left out, so you know its not artifact). The dog is acting seemingly normal. Still, however, you suspect insulinoma.
How do you proceed?

A. Hospitalize the dog and begin a dextrose bolus IV
B. Start on a high fiber diet such as r/d or w/d and advise the owner to feed small meals several times per day.
C. Give Karo syrup, feed meal and monitor the dog throughout the day.
D. Give a low dose IV CRI of dextrose throughout the day and monitor.

A

B

She has likely adapted to the low glucose, and only has clinical issues when she has a high demand for glucose, such as during exercise. Thus, giving her a bolus of dextrose would cause that insulinoma to release a lot of insulin in response, possibly lowering her BG levels to lower than she’s adapted to, which could be very dangerous or even fatal.

35
Q

T or F:

A dog suffering from an insulinoma can present with icterus if the tumor is large enough.

A

Yes!
The pancreatic duct and bile duct empty at the same location in the duodenum, and are in such close proximity that a pancreatic tumor can obstruct bile flow.

36
Q

T or F:

A paraneoplastic syndrome that is associated with insulinoma is peripheral neuropathy.

A

True!

Causing hindlimb weakness

37
Q

T or F:

An important differential for insulinoma in an older large breed dog is hepatocellular carcinoma because its associated paraneoplastic syndrome causes hypoglycemia.

A

True

MOD Exam 3 (part 2) (2 decks)

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