Endocrine (Gram) Flashcards

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1
Q

Dermatologic differential diagnosis: PAIN 4 ME

A
  • Parasitic (fleas, scabies, demodex)
  • Allergic (environment, food, parasite, contact(
  • Immune mediated/Idiopathic/Idunno
  • 4 - other misc.
  • Microbial (bacteria, yeast, dermatophyte)
  • Endocrine (endogenous)
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2
Q

General concepts of endocrine disease

A
  • Middle aged animals
  • Alteration in hair coat (alopecia, texture)
  • Underlying non-pruritic dz responsible for recurrent skin and ear infections (which can itch)
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3
Q

Primary hypothyroidism

A

Thyroid

  • Idiopathic atrophy
  • lymphocytic thyroiditis
  • neoplasia
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4
Q

Secondary hypothyroidism

A

Pituitary gland

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5
Q

Tertiary hypothyroidism

A

Hypothalamus

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6
Q

Sick euthyroid

A

Hypothyroidism induced by medications or just being sick

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7
Q

T4

A
  • most often measured clinically (important for testing)
  • made directly from the thyroid in higher amounts than T3
  • not as biologically active as T3
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8
Q

T3

A
  • more metabolically active than T4
  • mainly intracellular
  • 10-20% produced directly from thyroid
  • 80-90% derived from T4
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9
Q

Thyroid physiology

A
  • Turnover rate is higher in dogs than humans
    • replacement dose needs to be much higher
  • Thyroid hormones bind to proteins
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10
Q

Functions of thyroid hormone

A
  • Growth
  • Protein synthesis
  • Lipid metabolism
  • Carb metabolism
  • Hematopoiesis
  • Reproduction
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11
Q

Low thyroid effect on growth

A

Alopecia

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12
Q

Low thyroid effect on protein metabolism

A

Altered metabolism

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13
Q

Low thyroid effect on lipid metabolism

A

Elevated cholesterol

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14
Q

Low thyroid effect on hematopoiesis

A

Mild anemia

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15
Q

Low thyroid effect on reproduciton

A

Decreased

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16
Q

Dermatologic signs of hypothyroid

A
  • Seborrhea - dry & greasy
  • Recurrent infections
  • Hyperpigmentation
  • Dry, brittle hair coat
  • Alopecia
17
Q

Breed predilection for hypothyroidism

A
  • Golden retrievers
  • Doberman pinschers
  • Dachshunds
  • Great danes
  • Poodles
  • Boxers
18
Q

Diagnosis of hypothyroid

A
  • CBC (normocytic, normochromic, non-regenerative anemia)
  • Chem (incr. cholesterol & triglycerides)
  • Thyroid panel
19
Q

Thyroid panel w/ hypothyroidism

A
  • Low TT4, FT4
  • TSH (high w/ 1º, low w/ 2º & 3º
  • TT3, FT3 unreliable
20
Q

Factors affecting thyroid hormone concentrations

A
  • Age
  • Breed
  • Drugs
  • Illness (euthyroid)
  • Hypoproteinemia
  • Obesity
21
Q

Advantages of FT4 to TT4

A
  • Direct correlation w/ availability to tissues, rate of metabolism, and excretion
  • Less influenced by medical conditions and drug competition
22
Q

Skin Biopsy

A
  • Helpful but rarely diagnostic
  • Hyperkeratosis, follicular keratosis, incr. in telogen hair follicles suggests endocrine dz
23
Q

Hypothyroid treatment

A
  • Synthetic T4 supplementation
    • L-thyroxine
    • Solixine
24
Q

Reasons for therapeutic failure (hypothyroidism)

A
  • Wrong diagnosis, dose, product, frequency
  • Irregular admin
  • Failure to ingest meds
  • Poor absorption from the gut
  • Rapid metabolism/excretion
  • Auto-antibodies to T3, T4
  • Target organ resistance
25
Q

Types of hyperadrenocorticism (Cushing’s)

A
  • Iatrogenic (exogenous glucocorticoids)
  • Endogenous (adrenal, pituitary*)

*most common

26
Q

Dermatological signs of Cushing’s

A
  • Comedones (+/- demodex)
  • Recurrent infections
  • Demodicosis (mange)
  • Cutaneous atrophy
  • Hyperpigmentation
  • Calcinosis cutis
27
Q

Cushing’s tests

A
  • ACTH stim
  • Low dose dexamethasone suppression test
  • Serum ACTH concentrations
  • High dose dex suppression test
28
Q

Cushing’s in cats

A
  • Diabetes mellitus
  • Skin fragility
29
Q

Alopecia X - alternative names

A
  • Growth hormone responsive dermatosis
  • Adrenal sex hormone imbalance
  • PseudoCushings
  • Castration responsive dermatosis
30
Q

Alopeica X clinical signs

A
  • Bilaterally symmetrical alopecia
  • Head & extremities are spared
  • Hyperpigmentation
  • No systemic abnormalities
31
Q

Alopecia X diagnosis

A

R/O hypothyroidism and Cushing’s

32
Q

Alopecia X treatment

A
  • Not necessary
  • Melatonin
  • Castration recommended
  • Methyltestosterone (neutered)
  • Ketoconazole
  • Lysodren
  • Trilostain
33
Q

Sertoli cell tumor dermatologic signs

A
  • Resolve w/ castration
  • Bilateral, symmetrical alopecia
  • Hyperpigmentation
  • Seborrhea
  • Ceruminous otitis externa
  • Gynecomastia
  • Linear preputial dermatosis