Final Flashcards
1
Q
T/F: Thyroid levels are usually lower in humans than dogs
A
False
Lower in dogs than humans
2
Q
What type of diet do you want to use in a cat with DM?
A
Low carb
3
Q
What is the gold standart test for hypoT?
A
TSH stimulation test
4
Q
How would you diagnostically define a sick hypercalcemia patient?
A
Dehydrated
Azotemia
Weak
Ca x PO4 > 70
5
Q
Tx for cats with hypercalcemia?
A
High fiber diet
Prednisilone
6
Q
Normal value for TT4?
A
>35nmol/L
7
Q
What are the TT4, fT4, and TSH values in a dog with euthyroid sick syndrome?
A
TT4 - low
fT4 - normal
TSH - normal to low
8
Q
What is the ideal range of [BG] in a diabetic dog on insulin therapy?
A
100-250
9
Q
What are some common findings in a patient with hypoT?
A
Mild non-regenerative, normocytic, normochromic anemia
Horner’s syndrome
Delayed estrus
Alopecia
Hypercholesterolemia
10
Q
In hyperT animals, what 3 systems have increased function?
A
Heart
BP/vascular resistance
Kidneys
11
Q
What zones of the adrenal gland is Mitotane toxic to?
A
Fasiculata and reticularis
12
Q
What is the treatment of choice for ADH?
A
Surgery
13
Q
What is the doctor term for Addison’s?
A
Hypoadrenocorticism
14
Q
T/F: Patients with Cushings will have a stress leukogram
A
True
15
Q
What is the most common presenting problem with hyperparathyroidism?
A
Urocystolithiasis
16
Q
What values on your biochem profile will be decreased with Cushings?
A
Urea
Creatinine
17
Q
What is the best treatment for hyperT cats?
A
Iodine-131
18
Q
When adjusting insulin dose using nadir blood glucose, what do you do if the value is 5-10 mmol/L?
A
Dont change the insulin dose
19
Q
What are the signs of congenital hypoT?
A
Disproportionate dwarfism
Cretinism
HypoT
20
Q
If you have Ca<6, what are the two possible causes?
A
Eclampsia
Hypoparathyroidism
21
Q
What is deficient with atypical Addisons?
A
Glucocorticoids (cortisol) ONLY
22
Q
What do you use to pretreat an animal with pheochromocytoma before surgery?
A
Phenoxybenzamine 1-2 weeks prior
23
Q
Which form of primary adrenal failure develops first? Typical or Atypical?
A
Atypical
24
Q
What is the desired range of an ACTH stim test in an animal being treated with Trilostane that would not require alteration of dosage?
A
20-120nmol/L
25
What is the doctor term for Cushing's?
Hyperadrenocorticism
26
T/F: Patients with Cushings will have a high USG
False
27
What age dogs usually have thyroid tumors?
Middle-age to older
28
What should you do if you are treating a dog for hypoT and you see PU/PD/PP, nervousness, aggression, panting, excess weight loss, and fever?
Stop treatment for a few days and decrease the dose
29
What value on a hypoT test is the prognosticator in determining severity and survival?
fT4
30
What do you have to do when sending out a sample for ACTH assay?
Send frozen EDTA plasma
31
What is the most sensitive test for hypoT? Most specific?
Sensitive = TT4
Specific = TSH/T4
32
What is the specific treatment for glucagonoma hepatocutaneous syndrome?
Amino acid infusion IV
33
What type of insulin works best for cats?
Glargine/detemir or PZI
34
How much of the adrenal gland needs to be destroyed before you see clinical signs of Addisons?
\>85%
35
What condition is clinically identical to RMSF?
Acute ehrlichiosis
36
What are the signs of congenital panhypupituitarism?
Proportionate dwarfism
Juvenile mentality
Coat changes (maintain puppy coat)
Reproductive dysfunction (cryptorchid males)
37
What biochem abnormalities are associated with DKA?
Hyperglycemia
Metabolic acidosis
Large anion gap (\>30)
**Hypokalemia**
Hypophosphataemia (leads to anemia)
38
DDx for hypercalcemia?
Hyperparathyroidism
Addison's
Renal failure
Hypervitaminosis D
Idiopathic hypercalcemia of cats
Osteolysis
Neoplasia
Spurious
39
Which screening test has better sensitivity in screening for Cushings?
ACTH stim
LDDS
LDDS
40
When using Trilostane to treat a dog with Cushings, what monitoring test should you perform?
ACTH stim test 3-5 hours after treatment
41
Effect of hypoT on metabolism?
Decreased metabolic rate
42
What infectious disease can IVDD be confused with?
RMSF
Ehrlichiosis
Anaplasmosis
43
Which value on a thyroid test is least likely to be affected by euthyroid sick syndrome?
Free T4
44
What changes would you see on biochem in an animal with UDM?
Hyperglycemia
Elevated liver enzymes (normal bile salts)
Increased cholesterol
Glycated blood proteins
45
What type of diet do you want to use for a dog with DM?
Low fat (\<10%)
46
Effect of hypoT on growth?
Deficiency during development -\> cretinism
47
What ROA is best for administration of insulin for DKA?
IM
48
What 3 ticks are associated with RMSF?
Dermacentor
Rhiphicephalus
Amblyomma
49
What other disease mimics acromegaly in dogs?
Hypothyroidism
50
Fluid treatment for DKA?
High rates
K+ supplementation
PO4- supplementation
Give 20% of requirement in first few hours
0.45% saline or half-strength LRS
Dextrose in BG \< 250
0.9% saline if hyponatremia
51
What are the TGAA, cTSH, and T4 values in a patient with compensated hypoT?
TGAA - increased
cTSH - increased
T4 - normal
52
Medical therapy specific to insulinomas?
Glucocorticoids - increase gluconeogenesis and antagonize insulin
Diazoxide - inhibit insulin secretion
53
Cause of primary hypoparathyroidism?
Iatrogenic - post-thyroidectomy or parathyroidectomy
54
What must be done before giving insulin to a patient with hyperosmolar non-ketotic syndrome?
Restore hydration
55
What breed gets congenital secondary hypoT?
Giant schnauzer
56
When adjusting insulin dose using nadir blood glucose, what do you do if the value is \<5mmol/L?
Reduce insulin by 10%
57
What is the cut off value to rule out Addisons?
56
If greater then rule out Addisons
if less then do ACTH stim test
58
What does pheochromocytoma produce?
Catecholamine
59
What is the hallmark sign of hypercalcemia?
PU/PD
60
How do you differentiate eclampsia from hypoPTH?
Phosphorus will be high in hypoPTH
61
Which treatment for Cushings has more severe side effects?
Mitotane
62
T/F: When performing an ACTH assay, you will see increased ACTH concentrations with PD-HAC
True
63
What effects does diabetes have on the immune system?
Impaired NØ function
Decreased prostaglandin production
64
What do you do if fructosamine is \>500? \<300?
If \>500 increase insulin dose 5-10%
If \<300 decrease of stop insulin
65
You dose Mitotane daily until you see what clinical effects?
Reduced water intake
Loss of appetite
Vomiting
Lethargy/weakness
66
What medical conditions predispose animals to obesity?
Hypothyroidism
Hyperadrenocorticism
Neuter status
67
What are the TGAA, cTSH, and T4 values in a patient with lymphocytic thyroiditis?
TGAA - increased
cTSH - normal
T4 - normal
68
What is the most sensitive stand alone test for hypoT?
fT4
69
When adjusting insulin dose using nadir blood glucose, what do you do if the value is \> 15 mmol/L?
Increase insulin 10%
70
What causes necrolytic migratory erythema (NME)?
Glucagonoma
71
What are the TT4, fT4, and TSH levels in a dog with hypoT?
TT4 - low to normal
fT4 - low
TSH - high
72
What are the TGAA, cTSH, and T4 values in a patient with early clinical hypoT?
TGAA - increased
cTSH - increased
T4 - decreased
73
What test should you do for pheochromocytoma?
Metanephrine test
74
Best test to rule out Cushings?
Urinary cortisol:creatinine ratio
75
What should happen to PTH when TCa increases?
Should decrease
If within reference range = not appropriate
76
What is the diagnostic tool of choice for insulinomas?
Exploratory laparotomy
77
T/F: TSH is not affected with feline hyperthyroidism
True
78
ACTH stim test is better for which type of Cushings?
Pituitary dependent
79
What is the significance of fructosamines in DM?
Shows the last 2 weeks of glycemic control
Increased in recent cases
80
What is the only drug used for AD-HAC?
Mitotane
81
What changes would you see on UA of an animal with UDM?
Glucosuria
Cystitis
Ketosis
82
T/F: ACTH stim test is a differentiating test
False
83
What type of insulin works best for dogs?
Lente - vetsulin
84
What is the best treatment option for hyperT cats with renal disease?
Methimazole
85
If you are presented with a lactating bitch with tetany, what disease do you assume?
Hypocalcemia
86
What test do we use to monitor therapeutic response to Cushings treatment?
ACTH stim
87
What breed gets congenital primary hypoT?
Toy fox terrier
88
T/F: When performing an ACTH assay, you will see increased ACTH concentrations with AD-HAC
False
Decreased ACTH concentrations
89
What % protein do you want in a cat diet for DM?
50-55%
90
What range do you want to keep the fructosamine level?
350-400
91
Cushings test with the highest sensitivity?
Urinary cortisol:creatinine ratio (100%)
92
What are the TGAA, cTSH, and T4 values in a patient with advanced clinical hypoT?
TGAA - decreased
cTSH - decreased
T4 - decreased
93
Describe the appearance of the liver on US in an animal with a glucagonoma
Honeycomb liver disease
94
When adjusting insulin dose using nadir blood glucose, what do you do if the value is \>10 mmol/L?
Increase insulin by 5%
95
Clinical signs of hypoT?
Lethargy
Obesity
Cold intolerance
Skin (alopecia, hyperpigmentation, etc)
96
What happens if you give ADH to an animal with DI?
Rise in urine osmolality
97
In a LDDST, if there is a drop in cortisol concentration at 4 hours, and then an increase at 8 hours, what type of Cushings do you have?
Pituitary dependent
98
What is deficient with typical Addisons?
Glucocorticoids (cortisol) AND Mineralcorticoids (aldosterone)
99
50% of hypoT cases are caused by this
Lymphocytic thyroiditis
100
Which disease causes more of a bleeding problem? Monocytic Ehrlichiosis or RMSF?
Monocytic Ehrlichiosis
101
T/F: You can't interpret thyroid function in a dog on medication or one that is critically ill
True
102
What endocrine condition does hypercalcemia cause?
Nephrogenic DI - impaired renal tubular response to ADH
103
What is the Cushings test of choice when there is concurrent disease?
ACTH stim test
104
On advanced imaging for Cushings, which is bilateral and which is unilateral? (AD or PD)
PD is bilateral
AD is unilateral
105
Effect of hypoT on hair growth?
Hair is in telogen phase instead of anagen (causes alopecia)
106
Compare iCa in primary and secondary hyperparathyroidism
Primary - High
Secondary - low to normal, rarely increased
107
What fluids should be avoided with hypophosphatemia and therefore DKA?
Calcium containing fluids
108
Clinical signs of hypoT in cats?
Decreased fur on temples and pinnae
Weight gain
Decreased GFR
109
How do you diagnose panhypopituitarism?
GHRH stimulation test
110
What is the most important complication of diabetes?
Hypoglycemia
More common in the evening/at night (~6 hours after dose)
111
What ketones does the urine dipstick pick up?
Acetone
Acetoacetate
112
What lab findings will you see with Rickettsial diseases?
Anemia
Lymphocytosis
Proteinuria
Hypoalbuminemia/Hyperglobulinemia
113
Most common canine thyroid tumors?
Malignant invasive non-functional
114
If neoplasia is the cause of hypoT, how much of the thyroid must be destroyed?
\>75%
115
What ketones are not picked up by the urine dipstick?
Beta hydroxybutyrate
116
Medical therapy of hypoglycemia?
Small frequent meals of complex carbs
117
What breed has the lowest normal thyroid levels?
Greyhounds
