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SAM > Examination of the endocrine organs > Flashcards

Examination of the endocrine organs Flashcards

1
Q

What are the main endocrine organs

A 
Pituitary gland 
Thyroid gland- only palpable therefore the only one that can be examined directly 
Parathyroid gland 
Adrenal gland 
Pancreas
Ovaries/Testis
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2
Q

Typical/suggestive findings of inappropriate hormone function

A

In the history
Abnormalities of another organ system (similar to haemaotpoietic in this case)
Lab parameters

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3
Q

Steps of diagnostic approach

A 
Signalment 
History
Physical exam
Routine labs of blood and urine 
Hormone assays 
Diagnostic imaging
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4
Q

Signalment: dog

A

Hypothyroidism
DM
Cushing’s
Addison’s

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5
Q

Signalment cat

A

Hyperthyroidism

DM

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6
Q

Signalment- age

A

Juvenile- congenital
Young adult- Addison’s
Adult- hypothyroidism
Older- Cushing’s, DM, Hyperthyroidism

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7
Q

History

A 
Appetite 
PU/PD- almost always shown
Activity
Other organ system signs 
Previous med
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8
Q

Appetite

A

Polyphagia- hyperthyroidism, DM, Cushing’s

Inappetance- Addison’s

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9
Q

Other organ systems

A

Vomitting, diarrhoea
Neurological- hypoglycaemia, hypothyroid Ca
Skin- hypothyroidism and Cushing’s

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10
Q

Previous medication

A

NB!!
Can mimic or induce disease
GC’s- similar to Cushing’s
Trimethoprim sulphonamide- hypothyroidism

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11
Q

Lab exams

A

Blood and urine

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12
Q

Haematology

A

Biochem- glucose, ALKP, lipids, Na, K, Ca

Hormonal assays

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13
Q

Urinalysis

A

SG, glucose, ketone bodies
Secondary UTI’s
UCCR= urine creatinine cortisol ratio

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14
Q

Goal of carrying out the lab exams

A

Find the consequences of the hormonal disease e.g hyperglycaemia with DM
Find concurrent diseases e.g DM with pancreatitis
Exclude or diagnose other diseases with similar symptoms

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15
Q

Hormone assays

A

Blood or urine
Hypofunction- stimulation tests
Hyperfunction- suppression tests

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16
Q

Diagnostic imaging

A

To determine the size and structure of the endocrine gland
US
Radiographs
CT/ MRI

17
Q

US

A

Cervical: thyroid and parathyroid gland
Abdomen: adrenal glands and pancreas

18
Q

Radiographs

A

Secondary changes are indications
Urolithiasis
Hepatomegaly

*can’t figure out the endocrine disorders that would cause these

19
Q

CT/ MRI

A

Skull- pituitary gland
Cervical- thyroid gland
Abdomen- pancreas and adrenals

20
Q

Diseases of the Pituitary gland

A

DI (decrease in ADH)
Hyposomatotropism
Hypersomatotropism
Central hypercortisolism- Cushing’s (it would be secondary in this case?)- ACTH producing tumour

21
Q

Hyposomatotropism

A

Usually juvenile and congenital e.g in german shepheds
Proportional dwarfism
Puppy coat maintained

22
Q

Hypersomatotropism/ Acromegaly

A

Elderly cats and dogs caused by tumour causing an overproduction of the hormone
PU/PD weight gain
Enlarged head, paws, abdominal organs
Widening interdigital spaces

23
Q

Diseases of the thyroid gland

A

Hypothyroidism
Congenital hypothyroidism
Hyperthyroidism

24
Q

Hypothyroidism

A 
Decrease of T3 and T4
Obesity
Alopecia symmetrical
Hyperpigmentation
Thickened skin with mucin deposits 
Bradycard
Hypotherm

T4 and TSH measurement
For diagnosis- also need to conduct TSH stim test

25
Q

Congenital hypothyroidism

A

Congenital in male british short hair cats from 8 weeks
Disproportional dwarfism
Lethargy
Inappetence
Dehydration
Constipation! Characteristic as very rare in kittens usually

26
Q

Hyperthyroidism

A 
Increase of T3 and T4
PU/PD 
Weight loss
Unkept hair coat 
Masseter muscle atrophy- triangle-shaped head
Nervousness and aggression
Tachycard 
Increased metab
Palpable thyroid gland 
Diagnose with T4 measurement
27
Q

Diseases of the adrenal gland

A

Addison’s
Cushing’s
Pheochromocytoma
Primary hyperaldosteronism

28
Q

Addison’s

A 
Decrease of aldosterone and cortisol
Signs are very unspecific-
inappetance/ anorexia
Vomitting/ diarrhoea
PU/PD
Addison's crisis- hypovolemic shock, prolonged CRT
Increase K, decrease Na

Diagnose with ACTH stimulation test

29
Q

Cushing’s syndrome

A 
Increase cortisol (not so much aldosterone)
More typical symptoms!
PU/PD 
Polyphagia 
Enlarged urinary bladder
Abdominal enlargement- pot belly 
Muscle atrophy 
Alopecia 
Comedons 
Increase of SIAP

Diagnose: LDDST- low dose dexamethasone suppression test
Dynamic hormone testing is necessary- just cortisol is not enough

30
Q

Pheochromocytoma

A

Tumour of adrenal medulla producing adrenaline and noradrenaline

31
Q

Disease of the pancreas

A

DM
Cataracts more likely in dogs
Plantigrade more common in cats

SAM (16 decks)

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