Final Exam Material?

Question 1

If blood glucose <60mg/dL, insulin should drop. If blood glucose <60mg/dL and insulin is still high, what is the most likely differential?

Answer 1

Insulinoma

Insulin-producing tumor

Question 2

What are the most common causes of hyperglycemia?

Answer 2

• Glucocorticoids
• Catecholamines
• Diabetes mellitus
• Post-prandial

Question 3

Which of the following is decreased with liver disease?

• Glucose
• Cholesterol
• Urea
• Albumin

Answer 3

All of the above

Question 4

T/F: PLE is characterized by hypoalbuminemia and hyperglobulinemia

Answer 4

False

Protein Losing Enteropathy (PLE) is characterized by hy_po_albuminemia and hy_po_globulinemia

Question 5

What are the top two differentials associated with ketones in the urine?

Answer 5

Starvation state and Diabetic ketoacidosis

Question 6

How does hypomagnesemia contribute to hypocalcemia?

Answer 6

Without Mg, more Ca binds at parathyroid and decreases PTH production

Question 7

With hyperparathyroidism, you should expect to see hypercalcemia and hypophosphatemia

Answer 7

True

Question 8

You tried to reason with him, but your dog was acting a fool and feasted on some Warfarin. What coagulation factors are going to be affected?

Answer 8

II, VII, IX, X

• Two, seven, nine, ten*
• 二, 七, 九, 十*
• dos, siete, nueve, diez*
• deux. sept, neuf, dix*
• இரண்டு, ஏழு, ஒன்பது, பத்து*

Question 9

What is the best way to tell if a horse has a regenerative anemia?

Answer 9

Increased MCV

Remember that horses never release reticulocytes into peripheral blood

Question 10

What does basophilic stippling indicate in small animals?

Answer 10

Lead poisoning

Question 11

T/F: Amylase is specific for pancreatic injury

Answer 11

False

Question 12

Typically if lipase is > 2x upper end of normal, it is indicative of pancreatic injury. What is the exception to this?

Answer 12

Dogs receiving steroids

Question 13

T/F: Exocrine pancreatic insufficiency results in inadequate food absorption

Answer 13

False

• Exocrine pancreatic insufficiency results in inadequate food digestion*
• Need to differentiate this from malabsorption (Intestinal disease prevents absorption)*

Question 14

Trypsin-like Immunoreactivity (TLI) is a very sensitive and specific test for:

Answer 14

EPI

• (Exocrine pancreatic insufficiency)*
• In dogs:*
• TLI > 5.0 μg/L is normal
• TLI < 2.5 μg/L is EPI

Question 15

In cats, TLI levels less than ____μg/L is highly specific for EPI

Answer 15

In cats, TLI levels less than 8 μg/L is highly specific for EPI

Question 16

T/F: Calcitonin decreases serum Ca²⁺ concentration

Answer 16

True

• Calcitonin is produced by C cells of the thyroid gland and decreases serum Ca²⁺ concentration by inhibiting PTH*
• “Calcitonin tones it down”*

Question 17

T/F: Ethylene glycol toxicosis causes hypercalcemia

Answer 17

False

Ethylene glycol toxicosis is a cause of hypocalcemia

Question 18

T/F: Hypermagnesemia is seen only when renal function is compromised

Answer 18

True

Question 19

Hypernatremia is typically due to:

Answer 19

dehydration

Usually either inadequate water intake or pure water loss

Question 20

T/F: All causes of decreased Na⁺ are also causes of decreased Cl^-

Answer 20

True

Question 21

What are the most common causes of hyperkalemia?

Answer 21

• Oliguria/anuria
• urethral obstruction
• ruptured urinary bladder

Question 22

T/F: With hypertonic dehydration, [Na⁺] & [Cl^-] will be decreased

Answer 22

False

With hypertonic dehydration, [Na⁺] & [Cl^-​] will be increased

With hypotonic dehydration, [Na⁺] & [Cl^-​] will be decreased

Question 23

For blood gas analysis, which is better for evaluating acid base status:

Venous samples or arterial samples?

Answer 23

Venous samples

Question 24

What type of blood tube would you use for blood gas analysis?

Answer 24

Heparin (Green top)

Question 25

With **High Anion Gap Acidosis, **you'll observe an increase in nonvolatile acids. Name the nonvolatile acids:

Answer 25

**KLUE** * **K**etones * **L**actate * **U**remic acis (phosphates, sulfates) * **E**thylene glycol metabolites (toxins)

Question 26

Which ions are taken into consideration when calculation **anion gap**?

Answer 26

**Na⁺, K⁺, Cl^-, HCO₃^-**

Question 27

**Hy****_per_****ventilation** results in *what acid-base abnormality*?

Answer 27

**Respiratory Alkalosis** ## Footnote *"Reich at the campfire"*

Question 28

What would you expect too see with regard to PTH concentration in an animal with normal parathyroid function and hy**_per_**calcemia?

Answer 28

**[PTH] should be _decreased_**

Question 29

What test would you use to differentiate Diabetes Insipidus from psychogenic polydipsia?

Answer 29

**Water deprivation test** *If the animal releases ADH and concentrates its urine, it is psychogenic PD. If not, it is Diabetes insipidus* DO NOT PERFORM THIS TEST IN ANY ANIMAL THAT IS: * Suspected of having renal disease * Azotemic * Dehydrated

Question 30

T/F: Hy**_per_**adrenocorticism is unlikely in a dog with normal urinary cortisol:creatinine ratio (UCCR)

Answer 30

**True**

Question 31

What is the only test that will identify iatrogenic HAC?

Answer 31

**ACTH Stimulation Test**

Question 32

Which of the following does **not** have a primary role in maintaining water balance? * Sodium * Parathyroid hormone * Antidiuretic hormone (vasopressin) * Renin * Aldosterone

Answer 32

**Parathyroid hormone**

Question 33

Which of the following would you **not** expect to see in a dog with pituitary-dependent hy**_per_**adrenocorticism? * Hypergylcemia * Increased alkaline phosphatase (ALP) activity * Increased serum cortisol concentration * Increased gamma glutamyl transferase (GGT) activity * Lymphocytosis

Answer 33

**Lymphocytosis**

Question 34

What is the most common cause of hy**_per_**phosphatemia?

Answer 34

**Decreased glomerular filtration rate (GFR)**

Question 35

What would you expect to see happen to sodium and potassium levels in an animal with **aldosterone deficiency**?

Answer 35

**Decreased sodium, Increased potassium**

Question 36

Which organ system most frequently plays a direct role in an animal developing hy**_per_**kalemia?

Answer 36

**Renal system**

Question 37

What is the best test to differentiate malabsorption from maldigestion in the dog?

Answer 37

**Trypsin-like Immunoreactivity (TLI)**

Question 38

Which of the following is **not** a cause of lymphocytosis in the dog? * Chronic lymphocytic leukemia * Addison's disease * Cushing's disease * Ehrlichiosis * Recent exercise

Answer 38

**Cushing's disease**

Question 39

T/F: A **major crossmatch** involves incubation of the patient's erythrocytes with the donor's serum

Answer 39

**False** *A major crossmatch involves incubation of the _donor's_ erythrocytes with the _patient's_ serum*

Question 40

If we do a low dose Dex suppression (LDDST) test on a healthy dog, what would we expect to see after 8 hours?

Answer 40

**Cortisol \< 1.5 μg/dL at 4 & 8 h** *Cortisol secretion will decrease*

Question 41

If we do a low dose Dex suppression (LDDST) test on a dog with HAC, what would we expect to see after 8 hours?

Answer 41

**cortisol \> 1.5 μg/dL at 8 h** *Cortisol will _not_ suppress after 8 hours*

Question 42

T/F: Dogs with HAC will not secrete cortisol in response to ACTH stimulation

Answer 42

**False** *If you do an ACTH Stim test on a dog with HAC, you should see them _hypersecrete_ cortisol in response to that ACTH (\> 20 μg/dL)*

Question 43

If you're doing an ACTH stim test on a dog and there is no change pre- and post- ACTH administration, what is your conclusion?

Answer 43

**Iatrogenic HAC** *\*\*ACTH Stimulation Test is the only test that can confirm iatrogenic hyperadrenocorticism\*\**

Question 44

If you're doing a LDDST on a dog and at 8 hours cortisol is suppressed by more than half the baseline value, where is the lesion?

Answer 44

**Pituitary** *\*\*If it's not suppressed by at least half the baseline value, then it is an adrenal tumor\*\**

Question 45

What is the best interpretation for this data?

Answer 45

**Euthyroid Sick Syndrome**

Question 46

All of the following lab data suggests hyperthyroidism except: * Polycythemia * ↑ cholesterol * ↑ ALP * ↑ ALT * ↑ free T₄

Answer 46

**↑ cholesterol**