Endocrine Flashcards
T/F: no single test definitively diagnoses hypothyroidism
True
Ectopic thyroid tissue often localized in what areas?
Cervical
Mediastinum
Secretion and regulation of thyroid hormone is regulated by ?
TSH
What is the biologically active form of thyroid hormone?
Unbound
Enters cells -> bind receptors -> initiates changes
What are the effects of thyroid hormone?
CATABOLIC!
Increase metabolic rate Increase O2 consumption Stimulate erythropoiesis positive inotrope and chronotrope Catabolizes muscle and adipose tissue Alters lipoprotein metabolism
What are the 3 main thyroid function tests?
Total thyroxine (TT4) Free thyroxine (FT4) Thyroid stimulating hormone (TSH)
What thyroid panel is usually run in dogs?
Total thyroxine (TT4) Free thyroxine (FT4) Thyroid stimulating hormone (TSH)
What thyroid panel is usually run in cats?
Total thyroxine (TT4) only required*
Can run free thyroxine (FT4)
What is the gold standard for TT4?
Radioimmunoassay (RIA)
How does a radioimmunoassay function?
Known amountof T4 Ab is mixed with T4*(radiolabelled)
Serum is mixed with the Ab-T4*
T4 in serum will displace the Ab from T4*
T4-Ab complexes are measured for radioactivity
High radioactivity -> less serum T4
Low radioactivity -> more serum T4
What two assays measure unbound T4
Equilibrium dialysis (ED)- gold standard Radioimmunoassya (RIA)
What three assays are used to measure TSH?
Immunoradiometric
Chemiluminescent
ELISA
T/F: Assays measuring TSH are efficient at detecting both high a low concentrations of TSH
FALSE
Cannot detect low [TSH]
-> in hyperthyroid cats, dont bother running this because values of TSH will be too low to be detected
What are the two major disease syndromes of canine hypothyroidism ?
Primary - autoimmune disease
Secondary - pituitary gland neoplasia/congenital malformation/ trauma/surgery
Primary hypothyroidism results form???
Lymphocytic thyroiditis -> idiopathic thyroid atrophy
Thyroglobulin auto-antibodies (TGAA)
Lymphocytes and macrophages
Fibrous tissue
Clinical signs associated with hypothyroidism?
Fat, sleepy, lethargic, metal dullness
Weight gain
Cold intolerant
Bradycardia
Skin lesions: alopecia, increased shedding, poor hair coat
What may you see on a CBC in a dog that has hypothyroidism ?
Mild to moderate non-regenerative anemia
-decreased metabolic rate -> decrease O2 demand -> decreased EPO
What is the most common chemistry abnormality associated with canine hypothyroidism ?
Hypercholesterolemia
TT4 decreased
FT4 decreased
TSH incresed
Primary hypothyroidism
TT4 decreased
FT4 decreased
TSH decreased
Secondary hypothyroidism
What is the DDx for a decreased TT4?
Hypothyroid
Euthyroid sick syndrome
Spurious
What is euthyroid sick syndrome
Adaptive response to illness.
Absent clinical signs for hypothyroidism
TT4 decreased
FT4 normal
TSH normal
Euthyroid sick syndrome
What is the most common endocrine disorder of cats?
Hyperthyroidism
What is the pathogenesis of feline hyperthyroidism?
Functional adenoma (hyperplasia)
Over production of thyroid hormone
Clinical signs associated with hyperthyroidism
Palpable thyroid slip Tachycardia Polyphagia Hyperactivity Diarrhea
What may you expect to see on a CBC of a hyperthyroid patient?
Polycythemia
- increased metabolic rate -> increase O2 demand -> increased EPO
- T4 directly stimulates BM erythropoiesis
Heinz body formation
Stress leukogram
T/F: increases with ALT can be associated with hyperthyroidism
True
-severity correlates with TT4 levels
How does hyperthyroidism mask azotemia
Increased GFR due to increased cardiac output
Less muscle mass -> lower basal CREA
Will be unmasked with hyperthyroidism is treated!
What is the single, reliable test for diagnosing feline hyperthyroidism ?
Total T4
Will be increased (duh)