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RUSVM Clinical Pathology 2016 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What at the two hormones synthesized and secreted by regulation of TSH?

A

T4 (Thyroxine)

Triiodothyronine (T3)

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2
Q

What hormone is 100% synthesized by the thyroid?

A

Thyroxine (T4)

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3
Q

What are the thyroid hormone effects?

A 
Increase metabolic rate
Increase oxygen consumption, stimulates erythropoiesis
Positive inotrope
Positive chronotrope
Catabolize muscle & adipose tissue
Alters lipoprotein metabolism
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4
Q

What are the Thyroid function tests?

A 
Total Thyroxine (T4) 
Free Thyroxine (FT4) 
Thyroid stimulating hormone (TSH)
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5
Q

What does a Dog Thyroid Panel include?

A

TT4
Free T4
TSH

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6
Q

What does a Cat Thyroid Panel include?

A

Total T4

Free T4

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7
Q

What does Total T4 measure?

A

total circulating T4 (Protein bound and free)

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8
Q

What are the 2 common assays for measuring Total T4?

A

Radioimmuuunoassay

Snap ELISA test kit

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9
Q

What does Free T4 measure?

A

unbound circulating T4

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10
Q

What are the 2 common assay to measure Free T4?

A

Equilibrium Dialysis

Radioimmunoassay

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11
Q

What 3 assays measure TSH?

A

Immunoradiometric
Chemiluminescent
ELISA

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12
Q

Which test is the gold standard for measuring Total T4?

A

Radioimmunoassay

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13
Q

What is the most common cause of Canine Hypothyroidism?

A

Lymphocytic Thyroiditis

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14
Q

What are the clinical signs of Hypothyroidism?

A 
Fat 
Lethargy 
Weight Gain 
Skin lesions 
Bradycardia 
Hypothermia
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15
Q

What three things cause secondary hypothyroidism?

A

Neoplasia
Congenital malformation
Trauma or surgery

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16
Q

What hormone is not sythesized with secondary hypothyroidism?

A

TSH

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17
Q

What are the diagnostic clinical signs seen?

A 
nonregenerative anemia 
Hypercholesterolemia 
hypertriglyceridemia
Decreased Total T4 
Decreased Free T4 
Increased TSH
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18
Q

What are the diagnostic clinical signs for secondary hypothyroidism?

A

decreased total T4
decreased Free T4
decreased TSH

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19
Q

Euthyroid Sick Syndrome

A

Decreased Total T4
Absent clinical signs of hypothyroidism
TSH IS NORMAL!!

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20
Q

What else can cause euthyroid sick syndrome?

A

Glucocorticoids

Sulfonamides

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21
Q

Decreased Total T4

Increased TSH

A

Primary hypothyroidism

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22
Q

Increased TSH

A

Early hypothyroid?

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23
Q

Decreased Total T4
Decreased Free T4
Decreased TSH

A

Secondary Hypothyroidism

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24
Q

Decreased Total T4

Sometimes decreased Free T4

A

Euthyroid Sick Syndrome

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25
Q

Does a Canine Thyroid Carcinoma exhibit signs of abnormal thyroid function?

A

NO

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26
Q

What is the most common chemistry abnormality in hypothyroid dogs?

A

Hypercholesterolemia

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27
Q

What is the most common endocrine disorder of cats?

A

Hyperthyroidism

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28
Q

What is the pathogenesis of hyperthyroidism in cats?

A 
Functional adenoma (Hyperplasia) 
thyroid adenocarcinoma
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29
Q

What are the clinical signs of hyperthyroidism in cats?

A 
Tachycardia 
Polyphagia 
Weight loss 
Hyperactivity 
Diarrhea 
Palpable Thyroid slip
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30
Q

What are the diagnostic clinical signs of hyperthyroidism in cats?

A 
Polycythemia 
Heinz body fromation 
Stress Leukogram 
Increased liver enzyme activity (ALT) 
Azotemia - Dehydration and renal insufficiency
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31
Q

What is masked in Hyperthyroid cats?

A

Azotemia due to increased GFR

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32
Q

What is increased in Hyperthyroid cats?

A

Total T4

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33
Q

What is a common chemistry abnormality in hyperthyroid cats?

A

Increased Liver Enzyme Activity

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34
Q

What is the most reliable thyroid function test for hyperthyroid in cats?

A

Total T4

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35
Q

What do Chief Cells synthesize and secrete?

A

Parathyroid hormone

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36
Q

What is the function of Parathyroid hormone?

A

Increased plasma Calcium

Decreased plasma phosphorus

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37
Q

What stimulates PTH secretion?

A

Decreased Calcium

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38
Q

What inhibits PTH secretion?

A

Increased Calcium

39
Q

What conditions cause decreased PTH?

A

Calcitriol
Hypomagnesemia
Hypophosphatemia

40
Q

What condition increases PTH?

A

Hyperphosphatemia

41
Q

What does PTH promote?

A

Calcium resorption from the bone
Renal resorption of calcium
Formation of active Vitamin D
Increased Calcium resorption from intestine

42
Q

What does PTH inhibit?

A

Phosphorus resorption by the kidney –> increased phosphorus secretion in urine

43
Q

What are the two disease of the Parathyroid gland?

A

Primary hyperparathyroidism

Hypoparathyroidism

44
Q

What are the two causes of hypoparathyroidism?

A

Lymphocytic parathyroiditis

Iatrogenic

45
Q

What causes Primary Hyperparathyroidism?

A

Parathyroid Adenoma

46
Q

What on a chemistry panel can diagnose Parathyroid disease?

A

Total Calcium
Ionized Calcium
Phosphorus

47
Q

What endocrine test can confirm parathyroid disease?

A

Parathyroid Hormone Measurement

48
Q

What does a Parathyroid adenoma produce?

A

PTH

49
Q

What changes do you see on a chemistry panel with Hyperparathyroidsim?

A

Hypercalcemia
Hypophosphatemia
Normal to Increased PTH

50
Q

What are the other causes of hypercalcemia?

A 
D - Vitamin D Toxicosis 
R - Renal Failure 
A - Addison's Disease 
G - Granulomatous Disease 
O - Ostelytic Disease
N - Neoplasia
S - Spurious 
H - Hyperparathyroidism 
I - Idiopathic, Iatrogenic 
T - Temperature, Toxins
51
Q

What causes Hypoparathyroidism?

A

Decreased production of PTH

52
Q

What changes in the chemistry panel do you see with Hypoparathyroidism?

A

Hypocalcemia
Hyperphosphatemia
Normal to decreased PTH

53
Q

What hormones does the Adenohypophysis produce?

A 
ACTH 
Somatotropin (GH) 
MSH 
TSH 
FSH 
LH 
Prolactin
54
Q

What does the Neurohypophysis produce?

A

ADH/Vasopressin

Oxytocin

55
Q

What does ADH/Vasopression?

A

Water resorption in the kidney through aquaporins

56
Q

What are the two types of Diabetes?

A

Central

Nephrogenic

57
Q

What is deficient in Central Diabetes Insipidus?

A

ADH production

58
Q

What is wrong in Nephrogenic Diabetes Insipidus?

A

No response to ADH

59
Q

What are the clinical signs of Diabtetes Insipidus?

A

PU/PD

Low Urine SpGr

60
Q

What is the primary differential diagnosis for Diabetes Insipidus?

A

Psychogenic Polydipsia

61
Q

What are the three tests that differentiate between Central DI and Nephrogenic DI?

A

Water Deprivation Test
ADH Response Test
Modified Water Deprivation Test

62
Q

What types of animals do you NOT perform the water deprivation test on?

A

Azotemic
Dehydrated
Suspected of Renal Disease

63
Q

What is the diagnosis if the urine is concentrated after the water deprivation test?

A

Pyschogenic Polydipsia

64
Q

If the urine remains dilute after the water deprivation test what is the diagnoses?

A

Central Diabetes Insipidus

Nephrogenic Diabetes Insipidus

65
Q

What test is used to differentiate Central from Nephrogenic Diabetes Insipidus?

A

ADH Response Test

66
Q

If the Urine concentrates after the ADH Response test what is the diagnosis?

A

Central Diabetes Insipidus

67
Q

If the urine DOES NOT concentrate after the ADH Response test what is the diagnosis?

A

Nephrogenic Diabetes Insipidus

68
Q

What is Central Diabetes Insipidus characterized by?

A

Decreased ADH
PU/PD
Low USG

69
Q

What is Nephrogenic Diabetes Insipidus caused by?

A

Hypercalcemia
Drug induced: Glucocorticoids, halothane, nethoxyflurane, ethanol
Disease States: Pyometra, liver failure, etc

70
Q

Which disease is associated with interference at the level of the ADH receptor?

A

Nephrogenic DI

71
Q

What is the common name for Canine Hyperadrenocorticism?

A

Canine Cushing’s Syndrome

72
Q

What are the three forms of Hyperadrenocorticism?

A

Pituitary-dependent hyperadrenocorticism
Function adrenal tumor
Iatrogenic

73
Q

What are the clinical signs of Hyperadrenocorticism?

A 
PU/PD
Pot-bellied
Panting 
Muscle Weakness
Ligament Weakness 
Alopecia 
Calcinosis cutis
Cutaneous hyperpigmentation
74
Q

What are the Laboratory abnormalities seen with Hyperadrenocorticism?

A 
Stress Leukogram 
Increased ALP 
Increased ALT 
Increased Cholesterol 
Low Urine SpGr
UTI
75
Q

What are the screening tests for Hyperadrenocorticism?

A

ALP Activity

Urine Cortisol: Creatinine ratio

76
Q

What are the confirmatory/diagnostic tests for hyperadrenocorticism?

A

Low Dose Dexamethasone suppression test (LDDST)

AST Stimulating Test

77
Q

What are the differentiating tests for hyperadrenocorticism?

A

Low Dose Dexamethasone suppression test (LDDST)
High Dose Dexamethasone Suppression test (HDDST)
Endogenous ACTH measurement
Imaging

78
Q

What is frequently increased with hyperadrenocorticism?

A

ALP

79
Q

If the Urine Cortisol: Creatinine ratio is increase……

A

The patient has hyperadrenocorticism

80
Q

If the patient has a pituitary tumor with the LDDStest….

A

Cortisol production is not suppressed

81
Q

If the patient has an adrenal tumor with the LDDStest…

A

Cortisol production is NEVER supressed

82
Q

How do you interpret the LDDStest?

A

If decreased at 8 hours then the patient is Normal
If increased at 8 hours then the dog has not suppressed - hyperadrenocorticism
Step 2:
If increased at 4 hours - hyperadrenocorticism
If decreased then the dog has suppressed: PPDH

83
Q

What is the only test that will identify iatrogenic hyperadrenocorticism?

A

ACTH Stimulation Test

84
Q

How do you interpret the ACTH Stimulation test?

A

Dogs with hyperadrenocorticism hypersecrete cortisol

Dogs with iatrogenic hyperadrenocorticism: Flat Line (no change)

85
Q

If at 4 hours on the LDDStest cortisol suppressed by greater than 50% baseline value

A

PPDH

86
Q

What are clinical signs for hyperadrenocorticism in a Ferret?

A

Alopecia
Lethargy
Muscle Atrophy
Vulvar enlargment in females

87
Q

What are the clinical pathology findings of Ferrets with hyperadrenocorticism?

A

Anemia
Pancytopenia
Estrogen toxicosis

88
Q

What is thepathogenesis of Primary Hypoadrenocorticism?

A

Immune mediated destruction of adrenal cortices

89
Q

What is the pathogenesis of Secondary Hypoadrenocorticism?

A

Destructive lesion in the hypothalamus or pituitary resulting in less corticotropin-releasing hormone or less ACTH

90
Q

What are the clinical pathology findings of Hypoadrenocorticism?

A 
Lack of Aldosterone 
Hyponatremia 
Hypotension 
Pre-renal azotemia 
Addisonian Crisis
Lack of Stress Leukogram 
Nonregenerative Anemia 
Increased BUN 
Hypoglycemia
91
Q

What are the clinical signs of Hypoadrenocorticism?

A 
Anorexia 
Lethargy 
Thin 
Vomiting 
Weakness
Dehydration 
Bradycardia 
Melena
Hypothermia 
Painful abdomen
92
Q

What are the two ways to diagnose Hypoadrenocorticism?

A

Electrolytes

ACTH Stimulation test

93
Q

What is the test of choice for diagnosis of Hypoadrenocorticism?

A

ACTH Stimulation Test

RUSVM Clinical Pathology 2016 (22 decks)

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