endocrinology lectures -- settles

Question 1

this hormone is iodine containing

Answer 1

thyroid hormone

Question 2

T/F

T4 is greater than T3 in activity

Answer 2

FALSE

Question 3

which is the active form

T4 or T3

Answer 3

T3

Question 4

primary hypothyroidism is a disease of what tissue and accounts for what percent of hypothyroid cases?

Answer 4

thyroid gland - bc primary disease

95% of cases

Question 5

most of the primary hypothyroid cases are due to what?

Answer 5

lymphocytic thyroiditis – autoimmune disorder

Question 6

these 4 drugs can cause a low T4

Answer 6

􏰍 Glucocorticoids
􏰍 Carprofen
􏰍 Furosemide
􏰍 Phenobarbital

Question 7

what are 3 iatrogenic causes of low T4

Answer 7

􏰍 I131
􏰍 Antithyroid drugs
􏰍 Thyroidectomy

Question 8

T/F

the signalment for a hypothyroid dog is a really young small breed dog

Answer 8

FALSE – large breed middle aged dogs

Question 9

middle aged dog with lethargy, alopecia, hyperpigmentation, rat tail and seborrhea are all clinical signs pointing towards what endocring disorder

Answer 9

Hypothyroidism

Question 10

T/F

alopecia in a hypothyroid dog will be bilaterally symmetric

Answer 10

TRUE – endocrine disorders are all this way

Question 11

deposition of mucopolysaccharides in the dermis leading to a sad facial expression is known as

Answer 11

myxedema

Question 12

myxedema is seen in what endocrine disorder

Answer 12

hypothyroid dogs

Question 13

this “syndrome” will give low T4 results while everything else remains normal

Answer 13

euthyroid sick syndrome

Question 14

pituitary gland secretes this to stimulate the thyroid

Answer 14

TSH

Question 15

the hypothalamus secretes this to stimulate the pituitary to release TSH

Answer 15

TRH

Question 16

Lab results of a thyroid panel for a primary hypothyroid dog

Answer 16

Low T4, low FT4, HIGH TSH

Question 17

T/F

TSH will be low for primary hypothyroidism

Answer 17

FALSE – will be HIGH

Question 18

secondary hypothyroidism is an issue with what tissue

Answer 18

the pituitary

Question 19

what will the lab results for a secondary hypothyroidism dog be

Answer 19

LOW T4, low FT4, LOW TSH

Question 20

what happens to the cholesterol and trigs during hypothyroidism

Answer 20

they go up

hypercholesterolemia

Question 21

T/F

if you get a normal T4 reading back on lab work you can rule out hypothyroidism

Answer 21

TRUE

Question 22

what is the gold standard test for dx of primary hypothyroidism

Answer 22

TSH stimulation test

Question 23

what is the synthetic T4 drug of choice for treating hypothyroidism

Answer 23

levothyroxine

Question 24

when treating hypothyroid dogs, after how many weeks will the attitude be improved

Answer 24

1-2 weeks

Question 25

when treating hypothyroid dogs, after how many weeks will the derm be improved

Answer 25

4-6 weeks

Question 26

when treating hypothyroid dogs, after how many months will the hair growth be improved

Answer 26

2-3

Question 27

cat with these clinical signs: | Decreased fur on temples & pinnae, wt gain

Answer 27

hypothyroid cat

Question 28

what will be the results of a TSH stimulation test in a hypothyroid dog

Answer 28

no significant increase in post-T4 (due to thyroid gland atrophy or destruction) in a normal dog there would be an increase

Question 29

most common cause of hyperthyroidism in cats

Answer 29

functional adenoma

Question 30

old thin cat differentials

Answer 30

renal dz lymphoma inflammatory bowel dz hyperthyroid

Question 31

average age for a cat with hyperthyroidism

Answer 31

12

Question 32

most common endocrinopathy of cats

Answer 32

hyperthyroidism

Question 33

clinical signs of a cat with hyperthyroidism

Answer 33

``` scraggly coat (lol) pu/pd -- dilute urine vomiting diarrhea goiter tachycardia ```

Question 34

how to treat tachycardia from hyperthyroidism

Answer 34

beta blockers like propanolol -- thyroid works toward the beta receptors so small doses of propranolol can slow the heart rate and lower BP

Question 35

when palpating a hyperthyoid cats thyroid why is it important to go slowly

Answer 35

to prevent a thyroid storm

Question 36

T/F | cats have an inducible form of Alk phos

Answer 36

FALSE -- so this will be increased in hyperthyroid cats

Question 37

in a hyperthyroid cat's serum chemistry, will the ALT be higher, lower, or unchanged

Answer 37

HIGHER

Question 38

T/F | hypothyroid dogs have PU/PD

Answer 38

FALSE

Question 39

why is the azotemia in a hyperthyroid cat masked

Answer 39

the higher BP from the thyroid keeps the GFR up and so the azotemia is not noticed -- this is still causing damage to the kidney over time and is bad

Question 40

ideal treatment for hyperthyroid cat

Answer 40

30 days methimazole -- see if azotemia is unmasked first and treat the kidney issues THEN I131 good prognosis ^^ +5.3yrs

Question 41

this drug acts by inhibiting thyroid hormone synthesis by blocking incorporation of iodine 

Answer 41

methimazole (tapazole) -- hyperthyoid cat tx

Question 42

Excess glucocorticoids produced by adrenals.  

Answer 42

hyperadrenocorticism -- cushings disease

Question 43

which thyroid hormone can be absorbed across the cell membrane

Answer 43

free T4

Question 44

When treating a hypothyroid dog when should blood levels be drawn to evaluate therapy? a. 4-6 hours post pill after 1 month of treatment if the dog is on BID therapy b. 4-6 hours post pill after 2 weeks of treatment if the dog is on q24 hour treatment c. 8-12 hours post pill after 1 month of treatment if the dog is on BID therapy d. Peak and trough levels should be drawn after 1 month of therapy

Answer 44

a. 4-6 hours post pill after 1 month of treatment if the dog is on BID therapy

Question 45

What is the most appropriate test to differentiate pituitary dependent from adrenal dependent hyperadrenocorticism

Answer 45

abdominal ultrasound

Question 46

The following signs are most consistent with which disease? | Polyuria, Pot-bellied, Polydipsia, Polyphagia, Panting

Answer 46

hyperadrenocorticism -- cushings

Question 47

Which of the following helps to differentiate Cushing’s disease from hypothyroidism in dogs? a. Low Total T4 with hypercholesterolemia b. Polyuria/ polyphagia c. Obesity and hair loss d. Elevated ALP and weight loss

Answer 47

B

Question 48

differentials for PU/PD

Answer 48

``` Pyelonephritis Hypercalcemia Diabetes mellitus Drugs Liver disease ```

Question 49

Which of the following is most consistent with HAC? a. Stress leukogram, Elevated ALP, USG = 1.012 b. Mild neutrophilia, Elevated ALT, USG = 1.020 c. Mild anemia, Elevated Creatinine, USG = 1.012 d. Mild anemia, Elevated ALP, USG = 1.045

Answer 49

A

Question 50

Which of the following is most consistent with a diagnosis of Cushing’s disease? a. An elevated UCC and normal ACTH stim b. A borderline UCC and an elevated LDDS at 8 hours c. A low HDDS at 8 hours with an elevated UCC d. An elevated endogenous ACTH level

Answer 50

B

Question 51

What if the LDDS came back as positive for Cushing’s but not definitive for PDH? What is the best answer? a. Abdominal ultrasound b. HDDS c. Endogenous ACTH d. ACTH stim

Answer 51

Abdominal ultrasound

Question 52

form of hyperadrenocorticism that Causes bilateral adrenocortical hyperplasia

Answer 52

Pituitary dependent -- accounts for 80-85% of cases and mostly small breed dogs

Question 53

what will iatrogenic cushings do to the adrenal glands

Answer 53

bilateral atrophy

Question 54

calcinosis cutis is seen in what endocrine disorder

Answer 54

cushings

Question 55

destroys zonae fasciculata and reticularis of adrenal gland – permanent adrenal atrophy

Answer 55

mitotane - lysodren

Question 56

Selective and irreversible inhibitor of monoamine oxidase type B, helps restore central dopamine concentration and facilitates dopaminergic transmission

Answer 56

selegiline - anipryl

Question 57

Use in those patients whose owners do not want to use Lysodren for fear of its side effects or cost of Trilostane

Answer 57

selegiline

Question 58

Synthetic, orally active steroid analog; competitive inhibitor of the 3-􏰃-hydroxysteroid dehydrogrenase enzyme system thereby inhibiting synthesis of several steroids including cortisol and aldosterone

Answer 58

Trilostane

Question 59

Imidazole antifungal drug, lowers circulating cortisol concentrations by inhibiting steroid biosynthesis

Answer 59

ketoconazole