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Clinical Pathology Exam 4 > Lecture 3 > Flashcards

Lecture 3 Flashcards

1
Q

Who does hypothyroidism occur most commonly in?

A

Dogs

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2
Q

What causes hypothyroidism?

A

Immune mediated/ idiopathic

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3
Q

What are some clinical signs of hypothyroidism?

A 
Lethargy
Inactivity
Dullness
Weight gain without increased appetite
Alopecia/dull hair coat
Seborrhea
Cold intolerance
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4
Q

Hypothyroid CBC

A

+/- mild nonregenerative anemia
+/- codocytes

Overall boring

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5
Q

Hypothyroid chemistry

A

Hypercholesterolemia
Hypertriglyceridemia
Accumulation of plasma lipids

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6
Q

What causes hyperthyroidism? Who does it occur in?

A

Hyperplasia or adenoma of thyroid in cats

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7
Q

Clinical signs of hyperthyroidism

A 
Weight loss
Polyphagia
PU/PD
Restlessness
GI/vomiting
Skin changes
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8
Q

Common PE finding of hyperthyroidism

A

Palpable thyroid

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9
Q

Hyperthyroid CBC

A

May be normal RBCs or mild increase in PCV
Heinz bodies
May have stress or physiologic leukogram

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10
Q

Hyperthyroid chemistry

A

Mild increase in ALT and/or ALP

Azotemia (BUN, creatinine, Phos)

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11
Q

If you see moderate/marked increase in ALT and/or ALP in a hyperthyroid cat, what should you do?

A

Look for concurrent disease

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12
Q

What diseases are on your list with weight loss despite good appetite

A 
Hyperthyroidism
Diabetes
GI disease
Malabsorption
Maldigestion
Cushings
Poor diet
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13
Q

What causes increased ALT and ALP in hyperthyroidism

A

Hepatic hypoxia because increased oxygen utilization (ALT)

ALP may be from bone isoform or cholestasis

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14
Q

What causes azotemia in hyperthyroid cats

A

Concurrent kidney disease!

Uncomplicated hyperthyroidism should increase renal blood flow and GFR

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15
Q

Hyperthyroidism UA

A

Proteinuria

Subclinical UTI

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16
Q

What does zona glomerulosa do

A

Mineralocorticoids (aldosterone)

“Salt”

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17
Q

What does zona fasiculata do

A

Glucocorticoids (cortisol)

“Sugar”

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18
Q

What does zona reticularis do

A

Androgens (sex steroids)

“Sex”

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19
Q

What does medulla do?

A

Catecholamines (epi, norepi, dopamine)

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20
Q

What is hyperadrenocorticism?

A

Canine cushings disease

Overproduction of cortisol from pituitary neoplasm or adrenal cortex neoplasm

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21
Q

Cushing CBC

A

RBCs may be normal or may have mild increase in PCV
Stress leukogram and hyper-segmented neutrophils
+/- thrombocytosis

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22
Q

Cushings chemistry

A 
Increased ALP (dogs only- steroids)
Increased ALT
Increased cholesterol
Increased glucose
Decreased BUN
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23
Q

Cushings UA

A

Proteinuria
silent UTI
Dilute urine (because of ADH interference)

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24
Q

What is hypoadrenocorticism

A

Addisons disease
Destruction of adrenal cortex from immune mediated or idiopathic
Low cortico- and mineralocorticoids

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25
Q

Addisons CBC

A

RBCs may be normal or anemic
May have increased PCV from dehydration
Lack of stress leukogram “relaxed leukogram”

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26
Q

Addisons chemistry

A 
Azotemia
Low Na
Low Cl
High K
Decreased Na:K ratio
Low glucose
Low cholesterol
High Ca
Increase in liver enzymes
Metabolic acidosis
Low albumin
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27
Q

Addisons UA

A

Not fully concentrated urine despite being dehydrated (don’t confuse for renal failure)

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28
Q

What is atypical addisons

A

When an addisonian lacks electrolyte abnormalities

29
Q

What is hyperaldosteronism and who does it affect

A

Adrenal cortical neoplasia/hyperplasia in older cats

30
Q

What are clinical signs of hyperaldosteronism

A

Hypokalemia that causes polymyopathy and PU/PD

Hypertension (ocular manifestations)

31
Q

What is adrenal disease in ferrets

A

Adrenocortical hyperplasia/neoplasia

Secretes androgens/estrogens

32
Q

Ferret adrenal disease clin path findings

A

Often normal or may have anemia/pancytopenia due to estrogen toxicity

Urethral obstruction may be present causing azotemia, hyperkalemia, or low Na and Cl if there is a urinary rupture

33
Q

What is equine cushings

A

Pars intermedia dysfunction (PPID)

Occurs in aged horses and ponies

34
Q

Clinical signs of PPID

A 
Hirsutism
Laminitis
PU/PD
Weight loss
Increased sweating
Abnormal fat distribution
35
Q

PPID clin path findings

A

CBC: anemia, stress leukogram
Chem: hyperglycemia, hypertriglyceridemia
UA: glucosuria

Or all could be normal

36
Q

What is acromegaly and who does it affect

A 
Older cats (male disposition)
Pituitary ademona which secretes GH
37
Q

What does growth hormone do

A

Secretes IGF1

Insulin antagonist

38
Q

Acromegaly clin path findings

A

Weight gain and poor glycemic control

Often hyperproteinemic

39
Q

What is the most common disease of the endocrine pancreas

A

Diabetes mellitus

40
Q

What are classic signs of diabetes mellitus

A

PU/PD
Polyphagia
Weight loss

41
Q

Diabetes mellitus CBC

A

Normal in uncomplicated diabetic

Shouldnt see inflammatory leukogram unless there is concurrent disease

42
Q

Diabetes mellitus chemistry

A

Hyperglycemia
Hypercholesterolemia
Increased ALP and ALT (MILD)
Unpredictable electrolytes and minerals

43
Q

If you have diabetes and marked ALP/ALT, what should you think about?

A

Diabetes plus hyperadrenocorticism

44
Q

Diabetes UA

A

Glucosuria
Inappropriate concentration
+/- ketonuria
+/_ UTI, proteinuria, bacteriuria, WBC, RBC

45
Q

What is diabetic ketoacidosis

A

Occurs in diabetes complicated with other disease

Increased ketones because fats are being mobilized for energy

46
Q

What do ketones cause?

A

Contribute to acidosis (high anion gap)

Worsen osmotic diuresis and electrolyte depletion

47
Q

What could it be when you have unconcentrated urine and azotemia but NOT renal diseasen

A

Central diabetes insipidus (less ADH production)
Inhibition of ADH (high calcium, high cortisol, low sodium, low potassium)
Medullary washout (liver failure, Addisons)
Osmotic diuresis (diabetes mellitus)

48
Q

What does hypotriglyceridemia mean?

A

Nothing!

49
Q

Causes of hypertriglyceridemia

A 
Post prandial
Diabetes mellitus
Glucocorticoid (cushings, iatrogenic)
Hypothyroidism
Pancreatitis
Breed related
NEB/dyslipidemias
50
Q

Causes of hypercholesterolemia

A 
Post prandial (mild)
Diabetes mellitus
Cushings
Hypothyroidism
Cholestasis
Pancreatitis
Breed related
Nephrotic syndrome
51
Q

Causes of hypocholesterolemia

A

Malabsorption/maldigestion
Decreased liver function or failure i.e. PSS
Addisons
Neoplasia

52
Q

What diseases mobilize fat for energy?

A

Diabetes mellitus

NEB

53
Q

What ketones are produced from lipid metabolism

A

Acetone
Acetoacetate
BHB

54
Q

What are presence of ketones called in bovine and camelids?

A

Ketosis

55
Q

What are presence of ketones called in small ruminants

A

Pregnancy toxemia

56
Q

What are presence of ketones called in dog/cat

A

Ketoacidosis

57
Q

What species do not synthesis ketones

A

Horses

58
Q

When do non-esterified fatty acids increase?

A

Negative energy balance

Used mostly in cattle and camelids

59
Q

When cows are in NEB, what do they NOT have

A

Increased triglycerides and lipemia

60
Q

What is dyslipidemia

A

Disorder of lipid metabolism associated with abnormal amounts of circulating lipids

61
Q

What is hyperlipidemia

A

Blood does not appear lipemic

Can occur in any equid (trigs usually less than 500)

62
Q

What is hyperlipemia

A

Blood appears lipemic and trigs greater than 500

Occurs in donkeys, minis, and ponies

63
Q

What causes equine dyslipidemias

A

Insulin resistance causes NEB

64
Q

What are some causes of equine insulin resistance

A

Age, diet, anorexia, endocrine disease, obesity, inflammatory conditions

65
Q

What are predisposing factors of equine hyperlipidemia

A

NEB, insulin resistance, azotemia

*no fatty infiltration of organs

66
Q

What are predisposing factors of equine hyperlipemia

A

NEB, insulin resistance

Ponies- stress, weight loss, pregnancy/ weight loss
Mins/donkeys- underlying chronic illness

Causes fatty infiltration of organs and has a poor prognosis!

67
Q 
What do horses release in NEB?
Camelids?
Sheep/goats?
Cattle?
Dog/cat?
A 
Horses- trigs
Camelids- trigs and ketones
Sheep/goat- ketones
Cattle- NEFA
Dog/cat- ketones
68
Q

What is equine metabolic syndrome

A

Syndrome characterized by obesity, regional adiposity, insulin resistance, laminitis

May or may not have hyperglycemia and hypertriglyceridemia

69
Q

What are signs if an addisonian crisis

A

Hypovolemic/dehydrated

Bradycardic

Clinical Pathology Exam 4 (4 decks)

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