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Medicine 1 VCS860 > L1. Thyroid Endocrinology PT1 > Flashcards

L1. Thyroid Endocrinology PT1 Flashcards

1
Q
A

Thyroid regulation pathway

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2
Q

Thyroid Hormone:

Physiologic Effects:

Heart

A

Chronotropic

Inotropic

Enhance responses to circulatory catecholamines

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3
Q

Thyroid Hormone:

Physiologic Effect

Adipose tissue

A

Catabolic

Stimulate lipolysis

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4
Q

Thyroid Hormone:

Physiologic Effects

Muscle

A

Catabolic

Increase protein breakdown

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5
Q

Thyroid Hormone:
Physiologic Effects

Gut

A

Metabolic

Increase rate of carbohydrate absorption

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6
Q

Thyroid Hormone:

Physiologic Effect

Lipoprotein

A

Metabolic

Stimulate formation of LDL receptors

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7
Q

Thyroid Hormone:

Physiologic Effects

Other

A

Calorigenic

Increase metabolic rate

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8
Q

Total T4 (TT4) Diagnosis

A

Common screening test

Serum sample, randomly timed

Non-thyroidal illness and drugs can suppress TT4 (misdiagnosis)

Anti-T4 autoantibodies can interfere with assay (misdiagnosis)

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9
Q

Free T4 (FT4) Diagnosis

A

May be used as screening test

Serum sample, randomly timed

More specific than TT4 = more specific = fewer false postive

Non-thyroidal illness can suppress FT4 but effect is less than on TT4

Anti-T4 antibodies do not interfere with assay

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10
Q

TSH Measurement - Diagnosis

A

Serum sample, randomly timed, measured by immunoassay

Species-specific assay is needed

Poor screening test when used alone

Cannot be used as sole diagnostic test

More reliable when TT4 and/or FT4 levels also support the daignosis

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11
Q

INTERPRETATION

TSH - Normal

T4 - Normal

A

Condition - Normal

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12
Q

INTERPRETATION

TSH - Low

T4 - High

A

Primary Hyperthryroidism

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13
Q

INTERPRETATION

TSH - High

T4 - Low

A

Hypothryroidism Primary

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14
Q

INTERPRETATION

TSH - Low

T4 - Low

A

Hypothryroidism Secondary

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15
Q

Thyroid Diagnostic

Other hormone measurements

A

TT3, FT3, rT3 measurements

May be included on comprehensive thyroid panels

NOT useful for routine diagnosis

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16
Q

Anti-Thyroid Antibodies in Dogs

A

Anti-thyroglobulin

Anti-T4

Anti-T3

17
Q

Hypothyroidism

A

Diminished production and secretion of thyroxine (T4) and triiodothyronin (T3)

18
Q

Pathogenesis - Hypothyroidism

Lymphocytic Thyroiditis

A

Immune-mediated pathology/genetic influence

Presence of anti-thyroglobulin antibodies

Idiopathic follicular atrophy

19
Q

Pathogensis - Hypothyroidism

Congenital (cretinism)

A

Potbelly

Short statur

Abnormal Mentation

May/May not be fixed with hormone

20
Q

HISTORY - Hypothyroidism

A

Depressed mentation

Inactivity

Cold intolerance

Weight gain

Infertility - Female

21
Q

EXAMINATION - Hypothyroidism

A

Body condition - obese

Skin and coat

Ocular

Cardiac

Neuromuscular - Functional Change due to muscle loss

22
Q

Hypothyroidism

Physical Examination

Dermatologic Signs

A

Alopecia / slow hair regrowth - symmetric, not itching, bilateral, trunked

Dry skin with scaling

Dull brittle hair

Seborrhea

Pyoderma

Myxedema *

*Unique to thyroid disease, thick-skin around the head / face

23
Q

Hypothyroidism

Physical Examination

Ocular abnormalities

A

Lipid Accumulation - cornea, aqueous humor, retinal vessels

24
Q

Hypothyroidism

Physical Examination

Cardiac Abnormalities

A

Myocardial depression

Sinus bradycardia

weak apical beat

Decreased fractional shortening

Low voltage QRS complexes

Severe DCM in Great Danes - can be fixed with treatment

25
Q

Hypothyroidism

Physical Examination

Neuromuscular Abnormalities

A

Weakness

Knuckling / hyporeflexia

Slow, stiff gait

26
Q

Hypothyroidism

Physical Examination

Reproduction

A

Female infertility

27
Q

Hypothyroidism

Laboratory Abnormalities

CBC

A

Normocytic, Normochromic, Non-regenerative anemai (N3)

28
Q

Hypothyroidism

Laboratory abnormalities

Chemistry panel

A

No changes are diagnostic or pathognomonic

Lipid Abnormalities - hypercholesterolemia, hypertriglycidemai

Elevated ATP, ALP

Electrolyte disturbances

Creatine Kinase (Muscle)

29
Q

Interpretation of endocrine tests for suspected hypothyroidism:

Total T4

Free T4

TSH

A

Total T4: low

Free T4: Low

TSH: High

30
Q

Diagnosis of Canine Hypothyroidsim

A

Appropriate Clinical signs

Absence of other significant disease

Supportive lab results

Screen for Total T4

Confirm with FT4 ans TSH

31
Q

Hypothryroidsim

Treatment

A

Hormone replacement

Thyro-tabs

Steroid hormone can be given orally

32
Q

Treatment Follow-up

A

Recheck TT4 in 2-3 weeks after initiiating treatment

4-6 hours post pill blood draw for serum

Want TT4 to be high normal, or just above normal range

33
Q

Treatment Failure

A

Incorrect diagnosis

Poor owner compliance

Poorly controlled concurrent conditions

Medicine 1 VCS860 (13 decks)

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