review Flashcards
cushingoid case
been on allergy meds. resting cortisol 0.2, post stim 0.3. exogenous cushings. allergy med was probably steroid. low dose dex test- resting 6, 4hr post 3, 8hr, 2. pituitary dependent. look at the graph.
more cushingoid cases
acth stim- resting 2, post 3. hi dose dex 2.5, 8hr 2.6. adrenal tumors. will either look like pituitary cushings or wont stimulate at all.
diabetes insipidus
hyposthenuric cat. 8hr water dep 1.003. so didnt concentrate water. give DDAVP and urine increases to 1.0025. central DI. if respond to water dep, then psychogenic. if respond to ddavp with nothing, then nephrogenic DI. if after DDAVP goes up, central diabetes insipidus
diabetes mellitus case
6 unites NPH glycosuria. weird behavior after morning insulin. short acting insulin. too much insulin and not acting long enough. post hypoglycemic hyperglycemia. reduce insulin dose, split the dose of nph. not lasting full 24 hrs.
more diabetes
high glucose low k, ketones positive. dont give insulin when hypokalemic. rehydrate animal is important. dont give bicarbonate here.
hypoglycemia
40kg dog, give 1ml/kilo of 50% dextrose. it saves a brain.
a different cushings case.
previously diagnosed cushings, treated with opddd. recent progressive depression, vomiting, dehydration, depressed, brady. Brady with hypovolemia is inappropriate bradycardia. could be tentative addisons. treat for addisonian crisis. hyponatremia, hyperkalemia. no p waves. atrial standstill. give calcium gluconate. push potassium into cell-insulin and stuff. give saline, DOCP to replace aldosterone, dex and pred. calcium gluconate. give insulin. go home on pred and docp for rest of life
cat. case.
hyperthyroid, treated with tapazole, vomits meds. isosthenuric and azotemic. hyperthyroid causes hyperperfusion of kidneys. treated with i131, but thats bad. still isosthenuric. t4 undetectable. the hyperthyroidism was helping the kidneys out from the renal disease.
lethargy decreased appetite, pu/pd intact female dog
pyo. chemistry- glucose high, diabetic. fibringoen was up. radiographs show mass and stuff..
cookie lab pu/pd profound weakness
dehydrated, weak. pu/pd, metabolic disorder. recently loss of appetite. abdominal distension. no localizing neuro abnormalities. hyperkalemia. ketoacidotic diabetic. weak because potassium. iv fluids with k. delay insulin for 6-8 hrs. next day doing better.
hypoglycemia case
seizure and stuff weakness. if hypoglycemic, thats high insulin. inappropriate insulin level.
different case
mentally depressed, dehydrated, slow heart rate, scleral injection. vomiting. addisons. standard poodles. azotemic. hypotensive. hyponatremic, hypokalemic. give fluids and steroids. then test for cortisol. azotemic because blood pressure is too low to perfuse the kidneys. can the adrenals stimulate? give acth. give electrolytes. mineralocorticoid and glucocorticoid.
german shorthair pointer
right enlarged inguinal testicle, scrotal inflammation etc. nipples enlarged. masses in caudal abdomen. hyperestrinism. anemia? or aplastic hypoplastic? enlarged lymph nodes. maybe still have tumor releasing estrogen.
shivering, not herself, inappetent
mild hyperca.hypopa in past. underweight, alopecic, anal sac thickened. hypercalcemia, low phosphorus. bladder stones. mass aspirate- spindle cells, no atypia. ecg second degree block. pthrp is normal. pth normal. not normal if pth normal with high calcium. relatively elevated. parathyroid mass removed.
