Endocrinology Flashcards
What is sensitivity and specifity of the upper reference limit of 3,56nmol/L for diagnosis of pheochromocytoma in dogs?
Sensitivity : 100% CI :72-100
Specificity : 94% CI : 79-99
Ref : JVIM 2022, Berg, reference intervals for plasma urinaire and salivant concentrations of free metanephrines in dogs : releva ce to thé diagnostics of pheochromocytoma
What is the optimal cutoff of plasma normetanephrines for the diagnosis of pheochromocytoma in dogs?
3.1 nmol/L
Ref : JVIM 2022, Berg, reference intervals for plasma urinaire and salivant concentrations of free metanephrines in dogs : releva ce to thé diagnostics of pheochromocytoma
Between plasma normetanephrines and plasma metanephrine, which one has the best diagnosis performance for pheochromocytoma in dogs?
Plasma normetanephrines (Se 100% Sp 94%) has the best diagnosis performance.
Metanephrines (Se 73% Sp 94%)
Ref : JVIM 2022, Berg, reference intervals for plasma urinaire and salivant concentrations of free metanephrines in dogs : releva ce to thé diagnostics of pheochromocytoma
What part of the parathormon should be assayed to evaluate parathyroid function ?
The intact PTH (not its fragments)
Ettinger
Which factors regulate the second hydroxylation by the kidney of vitamin d to produce calcitriol ?
PTH stimulates. Increase in phosphorus downregulates.
Ettinger
How many dogs with primary hyperparathyroidism have more than one parathyroid gland involved ?
<10%
Ettinger
What are the occurence rate of adenoma, hyperplasia and carcinoma for dogs with primary hyperparathyroidism?
87% adenoma, 8%hyperplasia, 5% carcinoma
What are the half lives of T4 and T3 in dogs ?
T4: 10-16h
T3: 5-6h
Ettinger
How many greyhound, Basenjis, sloughis, salukis and whippets have low TT4 ?
Greyhound 90% , Basenjis 75% , Sloughis 65% , Salukis 55% , Whippets 25%
What is the peak concentration time of oral T4 ? And half life ?
Peak 3-5hours
Half life 9-15hours
Ettinger
Hyperthyroidism in cats often is a unilateral disease or bilateral disease ?
Bilateral in more than 2/3 of cases
Ectopic in 4% of cases
Ettinger
Which assay is more specific of feline hyperthyroidism : free T4 or total T4 ?
Total T4 is more specific, free T4 is highly sensitiv
Ettinger
What is the frequency of adenomas among canine thyroid tumours ?
10-30% of canine thyroid tumours are adenomas
Ettinger
How many dogs with a thyroid carcinoma have hyperthyroidism ?
10%
Ettinger
What is the preferred location of insulinomas ?
One the pancreatic limbs (80%)
Ettinger
What is the rate of metastasis of insulinoma ?
45-64%
Ettinger
How many dogs with insulinoma have high insulin level in blood ?
76% if measured on 1 sample, 91 % if measured on 2 sample
Ettinger
How many masses are detected by abdominal US in dogs with insulinoma ?
56%
Ettinger
How many dogs with insulinomas will have a diabetes mellitus after the surgery ?
10% will need insulin treatment (1 to 37 months)
Ettinger
How many dogs with diabetes mellitus suffer from cataract ?
14% at diagnosis, 50% at 170 days and 80% at 470 days
Ettinger
How many pituitary tumors of dogs with pituitary dependant hyperadrenocorticism arise from the pars distalis ?
70%. 30% arise from the pars intermedia
Ettinger
Does the type III procollagene propeptide increase or decrease in feline hypersomatotropism ?
Increase (collagene turnover)
Could the ghreline level be useful in the follow up of treated cats with hypersomatotropism?
Yes, it should increase (because ghreline is a secretagogue of GH)
Is ghrelin more potent than GHRH to induce synthesis and secretion of GH in young dogs ?
Yes
True or false: hypothyroidism is associated with increased level of GH and IGF-1 in dogs ?
True
Congenital hyposomatotropism in German shepherd is frequently associated with other hormones deficiencies, which one?
LH, FSH, Prolactine, TSH (but not ACTH)
What are the trigger factors for the release of ADH ?
Increase in plasma osmolality, a decrease in blood pressure/volume (and AT II)
What are the action of ADH ?
Increasing kidney water resorption (aquaporine 2), vasoconstriction, release of CRH (ACTH release), release of VWf and ANP…
Does TT4 increase or decrease with age in dogs ?
Decrease
True or false: TMPS have the ability to inhibit TPO (thyroid peroxidase)
True
In what dog breed TT3 measurement may be useful for hypothyroidism diagnosis ?
Greyhound
In cats with suspected occult hyperthyroidism with TT4 within high normal range, what hormone could be measured ?
fT4
What test can be performed in cats with occult hyperthyroidism?
The T3 suppression test: T3 supplementation for 48h with TT4 and TT3 measured before and after supplementation
What hormone may have a role in the development of thyroid tumors in dogs ?
TSH
True or false: the majority of thyroid tumors in dogs are carcinomas (90%) and are non secreting (90%)
True
What are the 4 counter regulatory hormones of hypoglycemia ?
Glucagon, catecholamines, GH and glucocorticoids
Is the abdominal US highly sensitive for the diagnosis of insulinoma in dogs ?
No, only 56% of dogs with a pancreatic mass identified (higher but not perfect sensitivity of CT scan)
True or false: Dogs never develop diabetes mellitus after surgical treatment of insulinoma.
False, around 10% develop diabetes mellitus after surgery
What sex is predisposed to canine diabetes mellitus?
Female sex
True or false: the development of anti-insulin antibodies could be a cause of insulin resistance in the dog ?
True: switching to a porcine source of insulin could be considered
True or false: Dogs with PDH may have normal sized adrenal glands
True (around 25%)
True or false: Lack of suppression on a HDDST does not exclude PDH
True (some PDH dogs do not suppress even with HDDST)
What condition could increase a post ACTH cortisol concentration in cats ?
Hyperthyroidism
True or false: abdominal US is highly sensitive and specific to diagnose the presence of thrombus within the caudal vena cava but less sensitive to diagnose vascular wall invasion (still highly specific) when an adrenal tumor is present in a dog
True
Is CT scan highly sensitive and specific to diagnose vascular wall invasion in dogs with adrenal tumor ?
Yes
Which hormone may be also secreted in cats with primary hyperaldosteronism?
Progesterone
What is the zollinger Ellison syndrome ?
Gastrin overproduction by gastrinoma with gastric antral hypertrophy, hyperacidity and ulceration
What provocative tests can be useful in the diagnosis of gastrinoma in dogs ?
Secretin or Calcium stimulation tests
What are carcinoid tumors ?
Neuroendocrine tumors from neuroendocrine cells located in an epithelium, that secrete vasoactive substances (serotonin, kinins…)
What 2 other biomarkers could be useful for the diagnosis of hypersomatotropism in cats ?
Type III procollagen propeptide (increased)
Ghrelin (decreased)
Which species has exactly the same GH as dogs ?
Pigs
What stimulates ghrelin secretion ?
Fasting. (Food consumption decreases ghrelin secretion)
What are the other usually altered secretions in German shepherds with hyposomatotropism?
Gonadotropins, TSH and prolactin (not ACTH)
What are the 3 hormones obtained from preprovasopressin cleavage ?
ADH, neurophysin-2 and copeptine
Which cells produce parathormon and calcitonin ?
Parathyroid chief cells for PTH and C cells for calcitonin
How does hypercalcemia induce PUPD?
By inhibiting the action of ADH and the tubular resorption of Na-Cl
True or false: primary hyperparathyroidism is often associated with cystic structures in cats.
True
What particular ocular sign may be seen in dogs with primary hypoparathyroidism?
Lenticular cataract
Which thyroid autoantibodies are most frequent ?
Antithyroglobulin antibodies
What are the most frequent endocrine disorders in autoimmune polyendocrine syndrome type II?
Addison + hypothyroidism or diabetes mellitus
Which one is the most sensitive for diagnosis of hyperthyroidism in cats, TT4 or fT4?
FT4
Which test is the more specific for the diagnosis of hyperthyroidism in cats, FT4 or TT4?
TT4
What alternative drug exists when GI side effects are observed with oral methimazole in cats?
Transdermal methimazole or oral carbimazole
Name two factors that could be associated with the development of neoplastic hyperthyroidism in dogs.
Increased TSH and increased VEGF
What histologically defines malignancy in Canine thyroid tumors?
Vascular or capsular invasion
Which molecule is implicated in food induced hyperadrenocorticism in dogs ?
GIP: Gastric Inhibitory Peptide
What are the two most reliable criteria for malignancy in Canine adrenal tumors?
Vascular invasion and size >2cm
What have in common glucagon, GLP-1 and GIP?
They are all products of the same gene but in different cells (alpha cells of islet and L cells from the GI tract respectively)
