RUSVM Clinical Pathology 2016 > Endocrine > Flashcards

Endocrine Flashcards

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1
Q

What at the two hormones synthesized and secreted by regulation of TSH?

A

T4 (Thyroxine)

Triiodothyronine (T3)

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2
Q

What hormone is 100% synthesized by the thyroid?

A

Thyroxine (T4)

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3
Q

What are the thyroid hormone effects?

A 
Increase metabolic rate
Increase oxygen consumption, stimulates erythropoiesis
Positive inotrope
Positive chronotrope
Catabolize muscle & adipose tissue
Alters lipoprotein metabolism
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4
Q

What are the Thyroid function tests?

A 
Total Thyroxine (T4) 
Free Thyroxine (FT4) 
Thyroid stimulating hormone (TSH)
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5
Q

What does a Dog Thyroid Panel include?

A

TT4
Free T4
TSH

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6
Q

What does a Cat Thyroid Panel include?

A

Total T4

Free T4

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7
Q

What does Total T4 measure?

A

total circulating T4 (Protein bound and free)

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8
Q

What are the 2 common assays for measuring Total T4?

A

Radioimmuuunoassay

Snap ELISA test kit

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9
Q

What does Free T4 measure?

A

unbound circulating T4

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10
Q

What are the 2 common assay to measure Free T4?

A

Equilibrium Dialysis

Radioimmunoassay

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11
Q

What 3 assays measure TSH?

A

Immunoradiometric
Chemiluminescent
ELISA

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12
Q

Which test is the gold standard for measuring Total T4?

A

Radioimmunoassay

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13
Q

What is the most common cause of Canine Hypothyroidism?

A

Lymphocytic Thyroiditis

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14
Q

What are the clinical signs of Hypothyroidism?

A 
Fat 
Lethargy 
Weight Gain 
Skin lesions 
Bradycardia 
Hypothermia
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15
Q

What three things cause secondary hypothyroidism?

A

Neoplasia
Congenital malformation
Trauma or surgery

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16
Q

What hormone is not sythesized with secondary hypothyroidism?

A

TSH

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17
Q

What are the diagnostic clinical signs seen?

A 
nonregenerative anemia 
Hypercholesterolemia 
hypertriglyceridemia
Decreased Total T4 
Decreased Free T4 
Increased TSH
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18
Q

What are the diagnostic clinical signs for secondary hypothyroidism?

A

decreased total T4
decreased Free T4
decreased TSH

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19
Q

Euthyroid Sick Syndrome

A

Decreased Total T4
Absent clinical signs of hypothyroidism
TSH IS NORMAL!!

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20
Q

What else can cause euthyroid sick syndrome?

A

Glucocorticoids

Sulfonamides

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21
Q

Decreased Total T4

Increased TSH

A

Primary hypothyroidism

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22
Q

Increased TSH

A

Early hypothyroid?

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23
Q

Decreased Total T4
Decreased Free T4
Decreased TSH

A

Secondary Hypothyroidism

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24
Q

Decreased Total T4

Sometimes decreased Free T4

A

Euthyroid Sick Syndrome

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25
Does a Canine Thyroid Carcinoma exhibit signs of abnormal thyroid function?
NO
26
What is the most common chemistry abnormality in hypothyroid dogs?
Hypercholesterolemia
27
What is the most common endocrine disorder of cats?
Hyperthyroidism
28
What is the pathogenesis of hyperthyroidism in cats?
``` Functional adenoma (Hyperplasia) thyroid adenocarcinoma ```
29
What are the clinical signs of hyperthyroidism in cats?
``` Tachycardia Polyphagia Weight loss Hyperactivity Diarrhea Palpable Thyroid slip ```
30
What are the diagnostic clinical signs of hyperthyroidism in cats?
``` Polycythemia Heinz body fromation Stress Leukogram Increased liver enzyme activity (ALT) Azotemia - Dehydration and renal insufficiency ```
31
What is masked in Hyperthyroid cats?
Azotemia due to increased GFR
32
What is increased in Hyperthyroid cats?
Total T4
33
What is a common chemistry abnormality in hyperthyroid cats?
Increased Liver Enzyme Activity
34
What is the most reliable thyroid function test for hyperthyroid in cats?
Total T4
35
What do Chief Cells synthesize and secrete?
Parathyroid hormone
36
What is the function of Parathyroid hormone?
Increased plasma Calcium | Decreased plasma phosphorus
37
What stimulates PTH secretion?
Decreased Calcium
38
What inhibits PTH secretion?
Increased Calcium
39
What conditions cause decreased PTH?
Calcitriol Hypomagnesemia Hypophosphatemia
40
What condition increases PTH?
Hyperphosphatemia
41
What does PTH promote?
Calcium resorption from the bone Renal resorption of calcium Formation of active Vitamin D Increased Calcium resorption from intestine
42
What does PTH inhibit?
Phosphorus resorption by the kidney --> increased phosphorus secretion in urine
43
What are the two disease of the Parathyroid gland?
Primary hyperparathyroidism | Hypoparathyroidism
44
What are the two causes of hypoparathyroidism?
Lymphocytic parathyroiditis | Iatrogenic
45
What causes Primary Hyperparathyroidism?
Parathyroid Adenoma
46
What on a chemistry panel can diagnose Parathyroid disease?
Total Calcium Ionized Calcium Phosphorus
47
What endocrine test can confirm parathyroid disease?
Parathyroid Hormone Measurement
48
What does a Parathyroid adenoma produce?
PTH
49
What changes do you see on a chemistry panel with Hyperparathyroidsim?
Hypercalcemia Hypophosphatemia Normal to Increased PTH
50
What are the other causes of hypercalcemia?
``` D - Vitamin D Toxicosis R - Renal Failure A - Addison's Disease G - Granulomatous Disease O - Ostelytic Disease N - Neoplasia S - Spurious H - Hyperparathyroidism I - Idiopathic, Iatrogenic T - Temperature, Toxins ```
51
What causes Hypoparathyroidism?
Decreased production of PTH
52
What changes in the chemistry panel do you see with Hypoparathyroidism?
Hypocalcemia Hyperphosphatemia Normal to decreased PTH
53
What hormones does the Adenohypophysis produce?
``` ACTH Somatotropin (GH) MSH TSH FSH LH Prolactin ```
54
What does the Neurohypophysis produce?
ADH/Vasopressin | Oxytocin
55
What does ADH/Vasopression?
Water resorption in the kidney through aquaporins
56
What are the two types of Diabetes?
Central | Nephrogenic
57
What is deficient in Central Diabetes Insipidus?
ADH production
58
What is wrong in Nephrogenic Diabetes Insipidus?
No response to ADH
59
What are the clinical signs of Diabtetes Insipidus?
PU/PD | Low Urine SpGr
60
What is the primary differential diagnosis for Diabetes Insipidus?
Psychogenic Polydipsia
61
What are the three tests that differentiate between Central DI and Nephrogenic DI?
Water Deprivation Test ADH Response Test Modified Water Deprivation Test
62
What types of animals do you NOT perform the water deprivation test on?
Azotemic Dehydrated Suspected of Renal Disease
63
What is the diagnosis if the urine is concentrated after the water deprivation test?
Pyschogenic Polydipsia
64
If the urine remains dilute after the water deprivation test what is the diagnoses?
Central Diabetes Insipidus | Nephrogenic Diabetes Insipidus
65
What test is used to differentiate Central from Nephrogenic Diabetes Insipidus?
ADH Response Test
66
If the Urine concentrates after the ADH Response test what is the diagnosis?
Central Diabetes Insipidus
67
If the urine DOES NOT concentrate after the ADH Response test what is the diagnosis?
Nephrogenic Diabetes Insipidus
68
What is Central Diabetes Insipidus characterized by?
Decreased ADH PU/PD Low USG
69
What is Nephrogenic Diabetes Insipidus caused by?
Hypercalcemia Drug induced: Glucocorticoids, halothane, nethoxyflurane, ethanol Disease States: Pyometra, liver failure, etc
70
Which disease is associated with interference at the level of the ADH receptor?
Nephrogenic DI
71
What is the common name for Canine Hyperadrenocorticism?
Canine Cushing's Syndrome
72
What are the three forms of Hyperadrenocorticism?
Pituitary-dependent hyperadrenocorticism Function adrenal tumor Iatrogenic
73
What are the clinical signs of Hyperadrenocorticism?
``` PU/PD Pot-bellied Panting Muscle Weakness Ligament Weakness Alopecia Calcinosis cutis Cutaneous hyperpigmentation ```
74
What are the Laboratory abnormalities seen with Hyperadrenocorticism?
``` Stress Leukogram Increased ALP Increased ALT Increased Cholesterol Low Urine SpGr UTI ```
75
What are the screening tests for Hyperadrenocorticism?
ALP Activity | Urine Cortisol: Creatinine ratio
76
What are the confirmatory/diagnostic tests for hyperadrenocorticism?
Low Dose Dexamethasone suppression test (LDDST) | AST Stimulating Test
77
What are the differentiating tests for hyperadrenocorticism?
Low Dose Dexamethasone suppression test (LDDST) High Dose Dexamethasone Suppression test (HDDST) Endogenous ACTH measurement Imaging
78
What is frequently increased with hyperadrenocorticism?
ALP
79
If the Urine Cortisol: Creatinine ratio is increase......
The patient has hyperadrenocorticism
80
If the patient has a pituitary tumor with the LDDStest....
Cortisol production is not suppressed
81
If the patient has an adrenal tumor with the LDDStest...
Cortisol production is NEVER supressed
82
How do you interpret the LDDStest?
If decreased at 8 hours then the patient is Normal If increased at 8 hours then the dog has not suppressed - hyperadrenocorticism Step 2: If increased at 4 hours - hyperadrenocorticism If decreased then the dog has suppressed: PPDH
83
What is the only test that will identify iatrogenic hyperadrenocorticism?
ACTH Stimulation Test
84
How do you interpret the ACTH Stimulation test?
Dogs with hyperadrenocorticism hypersecrete cortisol | Dogs with iatrogenic hyperadrenocorticism: Flat Line (no change)
85
If at 4 hours on the LDDStest cortisol suppressed by greater than 50% baseline value
PPDH
86
What are clinical signs for hyperadrenocorticism in a Ferret?
Alopecia Lethargy Muscle Atrophy Vulvar enlargment in females
87
What are the clinical pathology findings of Ferrets with hyperadrenocorticism?
Anemia Pancytopenia Estrogen toxicosis
88
What is thepathogenesis of Primary Hypoadrenocorticism?
Immune mediated destruction of adrenal cortices
89
What is the pathogenesis of Secondary Hypoadrenocorticism?
Destructive lesion in the hypothalamus or pituitary resulting in less corticotropin-releasing hormone or less ACTH
90
What are the clinical pathology findings of Hypoadrenocorticism?
``` Lack of Aldosterone Hyponatremia Hypotension Pre-renal azotemia Addisonian Crisis Lack of Stress Leukogram Nonregenerative Anemia Increased BUN Hypoglycemia ```
91
What are the clinical signs of Hypoadrenocorticism?
``` Anorexia Lethargy Thin Vomiting Weakness Dehydration Bradycardia Melena Hypothermia Painful abdomen ```
92
What are the two ways to diagnose Hypoadrenocorticism?
Electrolytes | ACTH Stimulation test
93
What is the test of choice for diagnosis of Hypoadrenocorticism?
ACTH Stimulation Test
RUSVM Clinical Pathology 2016
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