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MOD Exam 3 > Endocrinopathies > Flashcards

Endocrinopathies Flashcards

1
Q

Diabetes should not be thought of as too much or too little glucose, instead it should be thought about in terms of too much or too little _______.

A

Insulin

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2
Q

T/F: The pituitary gland is protected by the BBB.

A

False

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3
Q

Conn’s Disease is an excess of mineralocorticoids.

A

True

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4
Q

From the hypothalamus to the neurohypophysis there are very long ______ ______ where they directly secrete ADH and Oxytocin into the blood stream.

A

Nerve terminals

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5
Q

Hormones can alter target organ protein synthesis but not effect gene transcription.
A. True
B. False

A

B. False

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6
Q

With high glucose levels, the concentration of insulin should be_________. With low glucose levels, the concentration of insulin should be ___________. With insulinomas even when the glucose levels are low [say, if a pet hasn’t had a meal in 24 hours], the insulin levels are still _______.

A

High, Low, High

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7
Q

If we get excessive amounts of TRH or TSH it can to the extent, alter gene expression where it can actually become a malignancy so we could develop an ________ or very rarely an ___________ in 2-3% of cases.

A

Adenoma, Adenocarcinoma

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8
Q

Endocrine homeostasis is mainly controlled by which mechanism?
A. Hypothalamic, pituitary neg. feedback.
B. Autonomous secretion
C. Paracrine control

A

A. Hypothalamic pituitary neg. feedback

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9
Q

Addison’s disease is a ________ of the adrenal glands, whereby _______ and _________ aren’t being made except in atypical Addison’s where just _________ aren’t made.

A

Hypofunction, Glucocorticoids & Mineralocorticoids, atypical where just glucocorticoids aren’t made.

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10
Q

_________ is when a gland starts to function autonomously to inhibition, ex: hyperparathyroidism, irrespective of the conc. of Ph and Ca2+, the parathyroid gland will continue to produce PTH, and here it is either hyperplasia or an adenoma.

A

Hyperfunction

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11
Q

Another name for growth hormone is___________.

A

Somatotropin

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12
Q

Somatotropin/GH is responsible for: Protein synthesis, Fat metabolism as an energy source, and Gluconeogenesis.
A. True
B. False

A

A. True

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13
Q

Somatotropin will be released in response to hypoglycemia; hypersomatotropism can cause insulin resistance and hyperglycemia.
A. True
B. False

A

A. True

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14
Q

Too much GH (growth hormone) is thought to account for 1/5-1/4 of the cases of __________ in cats.

A

Diabetes

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15
Q

When we are talking about GH deficiency, we are not talking about breed disposition to chondrodystrophy or miniature breeds, we are referring to __________ ___________.

A

Proportional dwarves [most commonly seen in German Shepherds].

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16
Q

An owner presents a 3 month old puppy with growth retardation, lanugo hair coat, truncal alopecia, delayed or absent tooth eruption, delayed epiphyseal closure and possibly a brachygnathism. This dog has a _________ _________ from ________ _________ deficiency and sometimes they will have _________ _________ deficiency, congenital Diabetes mellitus, portosystemic shunts, juvenile nephropathy, congenital heart defects, malnutrition and lysosomal storage diseases. These dogs also have a very juvenile mentality, shrill bark, difficulty in being house broken, males are often cryptorchid and females are in prolonged anestrus. Collectively this is referred to as___________.

A

Pituitary dwarfism, growth hormone, thyroid hormone, congenital panhypopituitarism.

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17
Q

The common culprit for congenital panhypopituitarism is a _________ __________ _______.

A

Rathke’s Pouch cyst

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18
Q

Acromegaly is ___________ which is the opposite to dwarfism in cats. Clinical signs include a ________ muzzle and ________ feet and may also develop _______ of the upper airways and have some stertor.

A

Hypersomatotropism, fleshy, large, hypertrophy.

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19
Q

It has been detected that 23% of _______ cats have acromegaly.

A

Diabetic

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20
Q

In dogs, they very rarely develop a pituitary tumor that leads to hypersomatotropism and instead it is due to excessive _________. This stimulates GH release by the ________ ________ and because of this they become hypertrophied. These patients usually also have _________.

A

Progesterone, mammary glands, hypothyroidism.

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21
Q

______ has the biggest impact on cellular function and feedback to the hypothalamic pituitary axis.

A

T3

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22
Q 
A cat diagnosed with acromegaly will most likely have which additional endocrinopathy?
A. Hyperthyroidism
B. Cushing's
C. Diabetes mellitus
D. Diabetes insipidus
A

C. Diabetes mellitus~ If there is evidence of insulin resistance, treating w/higher than normal levels of insulin….should consider acromegaly for sure.

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23
Q 
Which is the most metabolically active thyroid hormone?
A. T4
B. T3
C. TSH
D. fT4
A

B. T3~ produced in smaller amounts but it is the most active.

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24
Q

Thyroid hormone- increased fat, carbohydrate metabolism, basal metabolic rate, heart rate, strength of heart contraction, respiration and GI motility.
A. True
B. False

A

A. True

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25
Q

Hypothyroidism can be broken up into 2 major categories: ________ and ________. Where ________ accounts for >90% of all hypothyroid cases. The major cause of _________ hypothyroidism is _________ ________.

A

Primary & Secondary, Primary, Primary, Lymphocytic thyroiditis

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26
Q

Lymphocytic thyroiditis, idiopathic atrophy, congenital (cretinism), neoplasia (most are benign but some are malignant) and TMS are all causes of __________ hypothyroidism.

A

Primary

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27
Q

T/F: Congenital defects in the pituitary or hypothalamus are responsible for secondary hypothyroidism.

A

True

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28
Q

T/F: Other causes of hypothyroidism include iodine deficiency, decreased peripheral conversion of T4, and iatrogenically induced (via a thyroidectomy).

A

True

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29
Q

With cretinism the patient may have _______ ________.

A

Cognitive dysfunction

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30
Q

In order to check for hypothyroidism you can measure _______ and _______.

A

TT4 and fT4

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31
Q

Hyperthyroidism is excessive production of ________ and _______.

A

T4 and T3

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32
Q

The most common cause of hyperthyroidism in cats is what?

A

Functional tumors (autonomous tumors), specifically adenomas.

33
Q

70% of cats with hyperthyroidism have ________ tumors.

A

Bilateral

34
Q

Feline Hyperthyroidism can cause cardiomyopathy and hypertension.
A. True
B. False

A

A. True= when tx hyperthyroidism sometimes hypertension persists, and we unmask a chronic kidney disease. Will help develop HCM. Idiopathic of middle aged male cats.

35
Q

T/F: Thyroid carcinomas are generally benign, small, functional and may be cystic.

A

False, these are all the features of adenomatous hyperplasia/adenomas.

36
Q

Thyroid carcinomas accounts for _____ of all primary hyperthyroid cases.

A

2%

37
Q

Since surgery is not an option for thyroid carcinomas because they are infiltrating to the underlying tissue, the only thing you can do is ______ ______ them with ______ ______.

A

Medically manage them with Iodine 131

38
Q

If you are convinced a cat has hyperthyroidism but you can’t palpate hyperplasia/a thyroid slip, what could this mean?

A

The cat MAY have ectopic thyroid tissue, so beware!

39
Q

Clinical signs of hyperthyroidism include what?

A

PU/PD, GI signs (vomiting, diarrhea), and acting like a kitten.

40
Q

A quick and easy way to try and differentiate primary from secondary Cushing’s Disease is ultrasound. _______ is another good way to try and differentiate, but it doesn’t always work as a differentiating test, only as a confirmatory test of the disease.

A

LDDST (Low Dose Dex Suppression Test)

41
Q

If the adrenals are bilaterally enlarged then this is fairly indicative that the hyperadrenocorticism is what?

A

Secondary and caused from over secretion of ACTH by the pituitary gland.

42
Q

Is this statement correct? Cortisol will cause hyperglycemia by the following mechanism: stimulates gluconeogenesis, decreases glucose utilized by cells by decreasing insulin sensitivity.
A. True
B. False

A

A. True~ animals with Cushing’s have high incidence of Diabetes.

43
Q 
The adrenal cortex, zona glomerulosa secretes which hormone?
A. Cortisol
B. Norepinephrine
C. Aldosterone
D. Progesterone
A

C. Aldosterone

44
Q

Aldosterone secretion is controlled by potassium concentration and angiotensin II.
A. True
B. False

A

A. True

45
Q 
The hypothalamic pituitary pathway relies on which direct hormone combinations?
A. CRH +ve -->adrenal
B. ACTH -ve --> adrenal
C. Cortisol -ve --> pituitary
D. ACTH +ve --> hypothalamus
A

C. Cortisol -ve –> pituitary

46
Q

Small/toy breeds like miniature poodles, being female, PU/PD, bilateral alopecia, calcinosis cutis, a pot belly, polyphagia, susceptibility to musculoskeletal injury (like ACL tears) and thromboembolic are all signs or consequences of which disease?

A

Hyperadrenocorticism (Cushing’s Disease)

47
Q

A dog with hyperadrenocorticism due to a pituitary tumor will have?
A. Increased cortisol, decreased ACTH, decreased CRH
B. Increased cortisol, increased ACTH, increased CRH
C. Increased cortisol, decreased ACTH, inroads CRH
D. Increased cortisol, increased ACTH, decreased CRH

A

D. Increased cortisol, increased ACTH, decreased CRH

48
Q

This type of dog is overrepresented for pituitary dependent Cushing’s disease.

A

Middle aged, female, small breed dogs.

49
Q

T/F: Adrenal dependent Cushing’s patients account for about 10-15% and are typically large breed dogs.

A

True

50
Q

T/F: Cats are highly sensitive to the effects of cortisol.

A

False [Dogs are highly sensitive, cats are resistant].

51
Q

T/F: Myotonia can be a complication of Cushing’s.

A

True

52
Q

Immune mediated destruction, Mitotane/Trilostane, hemorrhage, infarction, infection and tumors can all induce ______.

A

Hypoadrenocorticism

53
Q

_____ of adrenal gland destruction must occur before clinical signs of Addison’s are apparent in the patient.

A

85%

54
Q

Secondary adrenal failure is caused from ______ _______.

A

Pituitary dysfunction (absent ACTH)

55
Q

Addison’s disease is where you have deficiency of both _________ and _________ in the typical form and in the atypical form just _________ deficiency.

A

Glucocorticoids and mineralocorticoids and atypical just glucocorticoids

56
Q

What is an Addisonian crisis?

A

Acute adrenal failure. The signs may be vomiting and diarrhea~hemorrhagic gastroenteritis due to poor perfusion of the GIT (and also the bladder) which will lead to dehydration, anorexia, pale mm, prolonged CRT, bradycardia, severe hypotension, hypoglycemia and hypercalcemia.

57
Q

T/F: Destruction of the adrenals occurs from the inside out (zone fasiculata to zona glomerulosa).

A

True, hence why atypical could progress to typical.

58
Q

Iatrogenic Addison’s could result from chronic use of ________ which leads to rapid suppression of ACTH.

A

Glucocorticoids

59
Q 
The diagnosis in a dog with a normal K+ and Na+ conc. but is hypotensive, hypoglycemic and no cortisol stimulation on a ACTH stimulation test is?
A. Addisonian crisis
B. Atypical Addison's disease
C. Septic shock
D. Glucagonoma
A

B. Atypical Addison’s Disease

60
Q

Alpha cells secrete ______.

A

Glucagon.

61
Q

Delta cells secrete ________ and regulates the control of glucagon and insulin and regulates GIT motility and resorption of chyle through the lymphatics.

A

Somatostatin (inhibits gastric secretion and release of somatotropin).

62
Q

Beta cells secrete _______ and ______.

A

Insulin and amylin

63
Q

A glucagonoma is a very rare condition where a tumor in the alpha cells leads to excess secretion of glucagon which will lead to increases in ______ ______ levels so patients can become _________.

A

Blood glucose, Diabetic

64
Q

In Type 1 Diabetes failure of the ______ ______ to produce ________ leads to a deficiency.

A

Islet cells, Insulin

65
Q

High carb diets in overweight animals can lead to exhaustion of the pancreas from excessive stimulation of the ______ ______ ______ and very high concentrations of _______ as well as ________ which is toxic and destroys these cells.

A

Beta islet cells, Insulin, Amylin

66
Q

Cats suffer from Type 1 Diabetes mellitus
A. True
B. False

A

B. False

67
Q 
Which is not a contributory factor to insulin resistance in cats.
A. Acromegaly
B. Hyperadrenocorticism
C. Obesity
D. Exercise
E. Glucagon
A

D. Exercise

68
Q

______ are the most common pancreatic tumors in dogs of which a high percentage are malignant. When diagnosed 45-64% have metastasized.

A

Insulinomas

69
Q 
The most likely etiology of hypoglycemia in a 10 y/o Golden Retriever with PU/PD and elevated ALKP/ALT is?
A. Hepatic carcinoma
B. Portosystemic shunt
C. Low glycogen reserves
D. Insulinoma
A

A. Hepatic carcinoma: associated with paraneoplastic syndrome which secretes insulin like growth factor which produces hypoglycemia.

70
Q 
The most likely etiology of hypoglycemia in a 7 week old toy poodle is?
A. Hepatic carcinoma
B. Portosystemic shunt
C. Low glycogen reserves
D. Insulinoma
A

C. Low glycogen reserves

71
Q 
The most likely etiology of hypoglycemia in an 8 y/o obese labrador with hind limb weakness is?
A. Hepatic carcinoma
B. Portosystemic shunt
C. Low glycogen reserves
C. Insulinoma
A

D. Insulinoma~hindlimb weakness probably a peripheral neuropathy

72
Q 
The most likely etiology of hypoglycemia in a  6 m/o Yorkshire terrier is?
A. Hepatic carcinoma
B. Portosystemic shunt
C. Low glycogen reserves
D. Insulinoma
A

B. Portosystemic shunt

73
Q

T/F: Calcitonin is secreted by the parathyroid gland.

A

False, calcitonin is secreted by the thyroid gland where as PTH is secreted by the parathyroid gland.

74
Q

Primary Hyperparathyroidism can be caused by what?

A

Autonomous (secretory), Tumor (adenoma and rarely carcinoma) or Hyperplasia. Associated with high iCa2+

75
Q

Secondary Hyperparathyroidism can be caused by what?

A

Can be secreted autonomously like primary. Renal disease/chronic kidney disease, nutritional (long standing nutritional deficiencies- low Ca2+ diet or a fish diet). iCa2+ is low to normal and rarely increased.

76
Q

A routine chemistry panel is done on a Keeshond dog showing hypercalcemia with no clinical signs. There are a # of reasons that the calcium may be elevated but you decide to put the animal on a 12 hr starve, then repeat that sample and measure the iCa2+. If it is persistently elevated, should be thinking it could be caused by _______ as a paraneoplastic syndrome, or by __________ ____________.

A

Lymphoma, Primary Hyperparathyroidism

77
Q

Dogs that have high levels of Ca2+ excreted in urine may develop _______ _______ _______.

A

Calcium oxalate uroliths

78
Q

T/F: Parathyroid masses are easily palpable in dogs.

A

False, they are rarely palpable and are infrequently seen at all in cats.

MOD Exam 3 (6 decks)

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