Endocrine Disorders Flashcards
caused by insufficient ADH, decreased kidney receptor responsiveness, pituitary tumours
clinical signs: unable to retain water
concerns: dehydration, hypovolaemia, hyperosmotic encephalopathy, hyper osmotic dehydration, hypernatremia, sudden water intake = cerebral oedema
Diabetes Insipidues
Causes: pituitary somatotroph adenoma causing overproduction of gonadotrophic hormone
Clinical signs: insulin resistant diabetes mellitus, acromegaly
Concerns: treated as diabetic patient with intracranial pressure concerns
Feline Hypersomatotropism
Causes: pituitary tumour , adrenal neoplasia\hyperplasia
Clinical Signs: increased cortisol (stimulates gluconeogenesis, protein/fat catabolism), polyuria (ADH), abdominal distension, respiratory muscle weakness, activation renin-angiotensin, increase response to catecholamines, decreased release vasodilatory prostaglandins, decreased hepatic function, hypercoagulability,
Concerns: Dehydration, electrolytes, hypoxia, hypercapnia, hypertension, increased stress response, delayed wound healing, short acting drugs.
Drug Interactions: Trilostane (adrenal necrosis, hypoadrenocorticism V+/D+), Selegiline (MAO inhibitor, NO OPIOIDS [seretonin syndrome], EPHIDRINE and PHENYLPROPANOLAMINE [hypertension and hyperexia]), NO NSAIDS
Hyperadrenocorticism (Cushing’s)
Causes: deficient aldosterone and/or glucocorticoid production, secondary caused by decreased ACTH secretion by pituitary tumour, hypothalamic lesion or prolonged negative feedback from exogenous corticosteroids.
Clinical signs: impairs renal excretion of water, decreases metabolism of proteins, fats and carbohydrates, decrease stress tolerance
Concerns: dehydration, electrolyes and acid bases, corticosteroid correction, low stress
hypoadrenocorticism (Addison’s)
Causes: adrenal tumour
Clinical signs: hypertension, excessive bleeding, arrythmmias
Concerns: hypertension and tachycardia with alpha adrenoreceptor blockers/beta adrenoreceptor antagonists(propranolol/atenolol),
Drug interactions: NO NMBA’s (due to anticholinergenics), NO KETAMINE, ETOMIDATE, DESFLURANE and NITROUS (stimulate sympathetic nervous system)
Pheochromocytoma
Causes: high plasma calcium concentration, chronic renal failure, hyperadrenocorticism
Clinical Signs: high calcium
Concerns: fix calcium levels, dehydration
hyperparathyroidism
Causes: low calcium levels
Clinical Signs: decreased myocardial contractibility, hypotension, AV blocks, seizures
Concerns: correct calcium, avoid hyperventilation (alkalosis = decrease Ca further)
Hypoparathyroidism
Causes: adenomatous hyperplasia, thyroid adenoma or adenocarcinoma
Clinical Signs: increased sympathetic nervous system, cardiac activity and metabolic requirements, hypertrophic cardiomyopathy (gallop rhythm, systolic murmur), renal disease (reduced elimination), tissue hypoxia, high glucose demand and CO2 production (increase drug metabolism), fractious
Concerns: renal function, hypoxia, medication choice, hypertension (beta blockers/ca channel blockers), stress, airway collapse, hypothermia.
Drug Interactions: NO KETAMINE, ETOMIDATE, DESFLURANE and NITROUS (stimulate sympathetic nervous system), glyco over atropine (O2 demand)
Hyperthyroidism
Causes:
Clinical Signs: overweight, decreased ventilatory response to hypoxia and hypercapnia, decreased myocardial contractility, impaired clearance of free water, hypoglycaemia, decreased metabolic rate,
Concerns: thyroid supplementation, electrolytes (Na), decreased anaesthetic requirements, + inotropes, vasopressors and ventilatory support available, aggressive IVFT, prolonged recovery (hypothermia)
Drug interactions: Phenobarbital, diazepam, trimethoprim/sulphonamide, quinidine, NSAIDs and glucocorticoids should be avoided as these decrease plasma concentrations of thyroid hormones.
Hypothyroidism
Causes: insulin deficiency 1, resistance to insulin 2
Clinical signs: chronic = damage and dysfunction of the kidney, eyes, autonomic nervous system, heart and vasculature, PUPD, increase natriuresis, diuresis causes lost K+ and Phosphorus, decreased immune function, ketoacidosis
Concerns: glucose monitoring, drug elimination, electrolyte balance, stress, correct ketoacidosis, keep routine, muscle wastage.
Drug Interactions: easily eliminated medications and reversible
Diabetes Mellitus
Causes: malignant pancreatic beta cell tumours
Clinical signs: hypoglycaemia, seizures
Concerns: not fasted for > 6 hours, glucosse and K+ checked, low fat meals post op
Insulinoma
