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Year 3 renal > endocrine / renal disorders > Flashcards

endocrine / renal disorders Flashcards

1
Q

How can hypoadrenocorticism can an acute renal emergency?

A
  • no aldosterone so very dilute urine
  • hypovolaemia if not adequate intake (e.g. Vom and dia)
  • reduced GFR - azotaemic + hyperkaelaemia so bradycardic
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2
Q

How do you diagnose hypoAC?

A

ACTH stimulation test

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3
Q

How do you long term manage hypoAC?

A

glucocorticoid and mineralcoticoid therapy for life

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4
Q

What is the function of calcium?

A 
intracellular second messenger
nerve conduction and neuro-muscular transmission
coagulation
muscle contraction
membrane stability
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5
Q

What 3 things control calcium?

A

PTH
VitD
calcitonin

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6
Q

how does PTH affect calcium?

A

increase calcium release from bone
increase calcium absorption from GIT
decrease calcium excretion from kidney

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7
Q

what hormone causes an increase in calcium and a decrease in phosphate?

A

PTH

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8
Q

How does VitD affect calcium?

A

increase calcium release from bone
increase calcium absorption from GIT
increase calcium reabsorption from kidney

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9
Q

how does calcitonin affect calcium?

A

decreases ca

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10
Q

what are the 3 components of total serum ca?

A

ionised 55%
albumin bound 35%
anion bound 10%

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11
Q

How can blood albumin affect Ca levels?

A
  • bound so if high serum albumin then get high total ca
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12
Q

what is the first thing you do when have hypercalcaemia?

A

repeat bloods

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13
Q

what are signs of hypercalcaemia?

A 
PU/PD
anorexia
dehydration
weakness / lethargy
V and D
facial puritis
oral discomfort
cardiac tachyarrhythmias
seizures/twitching
ARF
death
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14
Q

How does hypercalcaemia affect the kidney?

A
  • vasoconstricts afferent a - reduced GFR - azotaemia
  • decreases sensitivity to ADH - low USG
  • stops Na absorption out of LoH so alters conc gradient so get PU and low USG
  • if have high phosphate too get insoluble CaPO4 causing nephrocalcinosis and renal failure
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15
Q

what can cause hypercalcaemia?

A
  • growing animal
  • lipaemia
  • hypoAC
  • haemoconc
  • hyperproteinaemia
  • hyperPTH
  • PTHrP
  • renal failure
  • high VitD
  • granulomatous disease (macrophages contain vit D)
  • skeletal lesions
  • idiopathic in cats
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16
Q

what are 2 key toxins that can increase VitD?

A

psoriasis cream

rat poison

17
Q

what are 2 key neoplasms that release PTHrP?

A

lymphoma

anal sac adenocarcinoma

18
Q

what are some temporary treatments for hypercalcaemia?

A 
diuresis
bisphosphonates
calcitonin
furosemide
dialysis
19
Q

what are signs of hypocalcaemia?

A 
muscle tremors/ cramps
stiff gait
behaviour changes
panting
hyperthermia
tacchycardia
hypotension
death
20
Q

what can cause hypocalcaemia?

A 
CRF
eclampsia
acute pancreatitis
iatrogenic
ethylene glycol toxicity
malabsorption
hypoPTH
21
Q

how can you treat acute hypocalcaemia?

A

calcium gluconate

22
Q

what is hypersomatotrophism?

A

high GH - liver (with insulin) - high IGF1

23
Q

what is the difference in causes of hypersomatotrophism in dogs and cats?

A

cats - pit tumour

dogs - normal mammary tissue producing excess GH (hyperprogesteronaemia)

24
Q

what are some clinical signs of hypersomatotrophism?

A 
soft tissue and flat bone proliferation
thick set face
increased interdental spaces
PU/PD
polyphagia
wt gain
25
Q

when would you be highly suspicious of hypersomatotrophism in cats?

A

poorly controlled DM from insulin resistance

26
Q

how can you diagnose hypersomatotrophism?

A
  • serum IGF high
  • MRI for cat
  • abd US and serum P4 for dog
27
Q

what can predispose dogs to hypersomatotrophism?

A

entire

progestin administration

28
Q

How do you treat hypersomatotrophism in cats and dogs?

A

dogs - remove P4

cat - radiation, dopamine agonist, refer to RVC

29
Q

what causes hyposomatotrophism?

A

congenital malformation of pituitary adenohypophysis or trophic cell producing lines

get low GH, low TSH

30
Q

what are the signs of hyposomatrotrophism?

A

small stature
immature hair coat
persistent oestrus
hypothyroidism too

31
Q

how do you diagnose hyposomatotrophism?

A
  • low serum IGF1

- spinal rads at 6mo - persistent epiphyses

32
Q

what is the pathogenesis of central diabetes insipidus?

A

post pit not making ADH - CD impermeable to water - dilute urine

33
Q

what level of PD is seen with DI?

A

> 200ml/kg/24 hr

34
Q

how do you diagnose DI?

A

USG < 1.008
water deprivation test (be careful)
give desmopressin and see if USG increases

35
Q

how do you teat DI?

A

desmopressin

Year 3 renal (7 decks)

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