Term
| The Three main diseases with secondary hypertension ( two are endocrine) |
|
Definition
| Hyperthyroid, Cushings, Kidney dz |
|
|
Term
| What are the cutoff values that generally define a. polyuria and b. poldypsia |
|
Definition
| a. 100 mL/Kg/day b. 50 mL/Kg/day |
|
|
Term
| Which form of hypertension is anxiety associated |
|
Definition
|
|
Term
| Which form of hypertension is rare in vet med |
|
Definition
| Primary Idiopathic Hypertension |
|
|
Term
| You have a patient with persistent hypertension with normal CBC, chem panel, and UA. You have what looks like primary hypertension but what disease is hard to rule out? |
|
Definition
|
|
Term
| Target organs of hypertension |
|
Definition
| Kidney, Heart, Eye, Brain |
|
|
Term
| What is the main clinical manifestation of kidney damage secondary to hypertension? |
|
Definition
|
|
Term
| What is the main clinical manifestation of cardiac damage secondary to hypertension? |
|
Definition
| Left Ventricular Hypertrophy |
|
|
Term
| Which technique is more accurate in determining systolic bp |
|
Definition
|
|
Term
| The cuff diameter for measuring bp should be _____% of limb circumference |
|
Definition
|
|
Term
| Values over _____/_____ are prob abnormally high bp's |
|
Definition
|
|
Term
| Two reasons to treat for hypertension |
|
Definition
| 1. evidence of EOD 2. Several abnormal readings |
|
|
Term
| You have a hypertensive cat with secondary retinopathy... what is your first line drug |
|
Definition
|
|
Term
| Which is more potent, T3 or T4 |
|
Definition
|
|
Term
| Thyroid hormone is important for normal growth, especially in these two systems: |
|
Definition
|
|
Term
| Does thyroid hormone have inotropic or chronotropic effects... or both? |
|
Definition
|
|
Term
| Two types of acquired primary hypothyroidism |
|
Definition
| lymphocytic thyroiditis or idiopathic |
|
|
Term
| Why is cretinism very rare in vet med now? |
|
Definition
| Improvement in husbandry and nutrition ( good iodine in diets) |
|
|
Term
| If you see secondary (aka in pituitary) hypothyroidism, you can safely assume it's: |
|
Definition
|
|
Term
| Will TSH be up or down in euthyroid sick syndrome? |
|
Definition
|
|
Term
| Do you get hypo- or hyper- pigmentation with hypothyroidism |
|
Definition
|
|
Term
| Why might a dog get pancreatitis secondary to hypothyroidism? |
|
Definition
| Prob because of high circulating lipids |
|
|
Term
| In which endocrinopathy will a secondary megaesophagus NOT go away with tx? |
|
Definition
|
|
Term
| What kind of anemia will you see with hypothryoid dogs if there is one? |
|
Definition
|
|
Term
| Assoc breed for hypothyroid that gets it younger than average |
|
Definition
|
|
Term
| What Cranial nerves can have dysfunction with hypothyroid |
|
Definition
|
|
Term
| Why might you get a leukocytosis with hypothyroid |
|
Definition
|
|
Term
| What electrolyte might be low in a sever case of hypothyroid? |
|
Definition
|
|
Term
| Which breed has lower baseline T4 |
|
Definition
|
|
Term
| Can you use a total T4 test better for ruling in or out Hypothyroidism |
|
Definition
| ruling out- the sensitivity is good but specificity is bad |
|
|
Term
| fT4 run with this method is still affected by autoantibodies |
|
Definition
|
|
Term
| What's a reason for poor sensitivity for TSH (which should be increased with hypothyroid) |
|
Definition
| Maybe we are checking when more progressed and there is "pituitary apathy" |
|
|
Term
| Why not use TSH stim to dx hypothtyroid?? |
|
Definition
|
|
Term
| What can cause a false increase in tT4 ( but only slight increase) |
|
Definition
|
|
Term
| What's the best test we have right now to evaluate thyroid hypofunction? |
|
Definition
|
|
Term
| What drug causes a true but reversible hypothyroid state and should be termianted when eveluating hypofunction |
|
Definition
|
|
Term
| Which drug really afects interpretation of thryoid hypofunction b/c causes dec tT4, dec fT4 and concurrent inc TSH??? |
|
Definition
|
|
Term
| Which two drugs cause a decrease in circulating T4 and affect hypofunction testing through the same mechanism |
|
Definition
| glucocorticoids phenobarbitol |
|
|
Term
| When initiating tx for hypothyroidism, what two very important rules must you follow about drug using: |
|
Definition
| Always start with brand name. Never use sustained release product |
|
|
Term
| What is the number one cause for dec tT4 in a cat |
|
Definition
|
|
Term
| What chemical in canned foods and another in upholstery may be assoc with feline hyperthyroidism |
|
Definition
|
|
Term
| Which breeds are more protected from feline hyperthyroid? |
|
Definition
|
|
Term
| What disease might feline hyperthyroidism mask? |
|
Definition
|
|
Term
| Systemic hypertension secondary to hyperthyroisim in cats may lead to _____ in eye and ______in kidneys |
|
Definition
| Retinal separation; Proteinuria |
|
|
Term
| Cats can get thyrotoxic hypertrophy of heart muscle- reversible or irreversible? |
|
Definition
|
|
Term
| Why might you get an erythrocytosis with hyperthyroid |
|
Definition
| Thyroid promotes erythropoiesis |
|
|
Term
| What biochem value might increase in feline hyperthyroid b/c of increased bone turnover? |
|
Definition
|
|
Term
| Most hyperthyroid cats are easily dx with Hx, clincial signs, and ______ |
|
Definition
|
|
Term
| Use fT4 for dx hyperthyroid cats only when you get back ____ for your tT4 |
|
Definition
|
|
Term
| With a TRH stim, what would you see happen to tT4 in a hyperthyroid cat |
|
Definition
|
|
Term
| What do you compare thyroid to in nuclear scintigraphy? |
|
Definition
|
|
Term
| For short term tx of hyperthryoid cats, can use this REVERSIBLE drug |
|
Definition
|
|
Term
| What are the four adverse side effects of methimazole |
|
Definition
| Facial/Neck pruritis; GI signs; Bone Marrow dyschrasias; Hepatotoxicity |
|
|
Term
| what drug is considered methimazole w/o side effects but may not be true |
|
Definition
|
|
Term
| Why can't cats be on antithyroid meds during I131 tx |
|
Definition
| because dont want atrophied thyroid to "wake up" and also get hit by the radioactive iodine |
|
|
Term
| What is the omst life threatening complication of ethanol and heat ablation tx of hyperthyroid? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Which two findings of Addison's are over represented in ATYPICAL ( one CBC one PE) |
|
Definition
|
|
Term
| Sometimes Addison's is hard to dx and signs may suggest disease of one of these three types: |
|
Definition
|
|
Term
| Almost all Addisonian dogs have PUPD- what is the main known mechanism |
|
Definition
|
|
Term
| Megaesophagus is a very rare manifestation with this disease but with tx should be reversible |
|
Definition
|
|
Term
| What is the first change you see on ECG with hyperkalemia |
|
Definition
|
|
Term
| What happens to P waves eventually with prolonged hyperkalemia |
|
Definition
|
|
Term
| You have a young dog with a hx of chronic illness that seems to respond well to fluids- what is high on your differential |
|
Definition
|
|
Term
| Only test to officially dx Addison's |
|
Definition
|
|
Term
| What is the main thing you should do with an acute addisonian crisis |
|
Definition
| Aggressive 0.9% saline fluid therapy |
|
|
Term
| If your acute addisonian has some bad ECG abnormalities- what should you add to your therapy? |
|
Definition
|
|
Term
| What drug is used to tx lack of aldosterone |
|
Definition
|
|
Term
| What do you do before you take your addisonian dog for a crazy weekend hike? |
|
Definition
|
|
Term
| is ADH or PDH cushings more likely to been seen a small dog |
|
Definition
|
|
Term
| What is Atypical cushings |
|
Definition
| True cushings but with an inability to detect high cortisol levels |
|
|
Term
| What are the 4 1/2 P's for Cushing's |
|
Definition
| Polyuria, Polydipsia, Polyphagia, Potbelly (Panting) |
|
|
Term
| Four potential causes for potbelly in cushings animal |
|
Definition
| Abd Fat, Hepatomegaly, Full Bladdr, Lax abd muscles |
|
|
Term
| Two endocrinopathies that cause facial nerve parylsis |
|
Definition
| Hypothyroid, Hyperadrenocorticism |
|
|
Term
| What's high on a Cushing's CBC other than WBCs |
|
Definition
| Mild erythrocytosis + Thrombocytopenia |
|
|
Term
| Two reasons why you get proteinuira in cushings dogs |
|
Definition
| Cortisol directly inc glomerular permeability; Secondary to hypertension |
|
|
Term
| What particular thyroid test will help you rule out hypothyroid in cushings pts |
|
Definition
| They should have a lower TSH |
|
|
Term
| Which cushnigs dx test is specific ut not very sensitive, is quick, but expensive |
|
Definition
|
|
Term
| Which type of cushings might you be able to differentiate in LDDS test? |
|
Definition
|
|
Term
| What is the best differentiation test for dx ADH cushing's |
|
Definition
|
|
Term
| Three drugs to tx cushing's are |
|
Definition
| Mitotane, Trilostane, ketoconazole |
|
|
Term
| Which drug actually destroys adrenal cortex cells and is therefore medical tx of choice for ADH patients |
|
Definition
|
|
Term
| What protocol has a goal of chemical ablation of the adrenal? "Medical Adrenalectomy" |
|
Definition
|
|
Term
| What is the goal of all Cushings drugs? |
|
Definition
| Maintain a borderline hypofunction state |
|
|
Term
| Drug induction period for Mitotane is longer or shorter when dealing with an ADH patient ( as opposed to PDH) |
|
Definition
|
|
Term
| For this drug, DO NOT use the labeled dose at once daily but instead do a lower dose twice daily. |
|
Definition
|
|
Term
| What test do you use to help you adjust your cushing's drugs? |
|
Definition
|
|
Term
| Which cushing's drug inhibits the entire p450 system and therefore has potential to interfere with more parts of cortisol pathway. (not shown to be more effective) |
|
Definition
|
|
Term
| Which cushings drug do you need to closely monitor ALT and AST? |
|
Definition
|
|
Term
| What is a very useless and very expensive cushing's drug that should NEVER be sued on PDH pts |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the main treatment for PDH with macroadenoma |
|
Definition
|
|
Term
| Cushing's is super rare in cats, but in those you see it, 50% are unregulated for this other endocrinopathy: |
|
Definition
|
|
Term
| What is very important to know about the skin in cushing's cats |
|
Definition
| very teary- will peel right off |
|
|
Term
| Name the five counter reg hormones |
|
Definition
| Cortisol, Catecholamines, Growth Hormone, Progesterone, Glucagon |
|
|
Term
| Production of this unwanted polpeptide is increased in insulin resistance |
|
Definition
|
|
Term
| With chronic hyperglycemia you actually get downregulation of glucose tranporters and insulin secretion. This is called: |
|
Definition
|
|
Term
| Why Polyphagia in IDDM dogs (be specific) |
|
Definition
| Decreased insulin prevents activation satiety center |
|
|
Term
| #1 diabeteic complication in dogs |
|
Definition
|
|
Term
| #1 diabetic complication in cats |
|
Definition
|
|
Term
| For a cat with diabetic neuropathy, you need to treat aggressively for glucose regulation alongside long-term tx with____________. |
|
Definition
|
|
Term
| What two lab values must you have to make an IDDM dx? |
|
Definition
| Persistent fasting hyperglycemia with glucosuria |
|
|
Term
| What can you test for to rule out a stress hyperglycemia |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What oral hypoglycemic drug is toxic to cats |
|
Definition
|
|
Term
| HOGS IN YARD for hypercalcemia |
|
Definition
| Hyper PTH, Osteomylelitis, Granulomatous dz, Spurious lab, Idiopathic cats, Neoplasia, Young animals, Addisons, Renal Fail, D ( hyper vitD ) |
|
|
Term
| How does Heterobilharzia cause hypercalcemia |
|
Definition
|
|
Term
| What causes hypercalcemia with high ionized calcium in cats? |
|
Definition
|
|
Term
| Whith shistomsomiasis and certain neoplasias, would you more likely see a high or low Phosphorus? |
|
Definition
|
|
Term
| With granulomatous disease, would you more likely see a high or low Phosphorus? |
|
Definition
|
|
Term
| A cat with hypercalcemia and low ionized calcium is due to: |
|
Definition
|
|
Term
| Hypercalcemia is more easily caused by an increase in: |
|
Definition
|
|
Term
| Top three causes of hypercalemia in dogs |
|
Definition
|
|
Term
| Three different mechanisms of hypercalcemia of malignancy |
|
Definition
| PTHrp, Osteolysis (from bone tumors), induced cytokines that induce bone reabsorption |
|
|
Term
| Most common cause of hypercalcemia of malignancy |
|
Definition
|
|
Term
| Sometimes carcinomas in cats can cause PTHrp what are the two of note ( but rare and not a good study) |
|
Definition
|
|
Term
| Dog come in with increased iCa and tCa, dec PTH, inc PTHrp |
|
Definition
| hypercalcemia of malignancy |
|
|
Term
| Young animal with mild increase Ca and P |
|
Definition
|
|
Term
| If you have unckecked chronic hypercalcemia what happens two organs get affected the most? |
|
Definition
|
|
Term
| Which diruetics do you avoid in treating hypercalcemia? |
|
Definition
|
|
Term
| Whats a good treatment to quickly decrease calcium levels along with diuretics |
|
Definition
|
|
Term
| _________ is the first choice insulin for diabetic cats. However, be careful never to do this_________ before administration due to pH sensitive precipitation. |
|
Definition
|
|
Term
| Obese diabetic dogs need this kinda diet___________, while non obese diabetic dogs can get away with this other diet______. |
|
Definition
| Prescription High Fiber; Senior |
|
|
Term
| What is a huge game changer in the therapy of diabetic cats beyond giving them insulin? |
|
Definition
|
|
Term
| What human hypoglycemic drug is toxic to cats |
|
Definition
|
|
Term
| This drug is a hail mary option for recalcitrant diabetic patients and works at slowly glucose absorption across enterocytes. As a result a major side effect is what? |
|
Definition
|
|
Term
| Which diabetic drug stimulates beta cells and therefore only a potential adjunct therapy in cats? |
|
Definition
|
|
Term
| Second choice insulin for diabetic cats |
|
Definition
|
|
Term
| First choice insulin for diabetic cats |
|
Definition
|
|
Term
| First choice insulin for diabetic dogs is _______ b/c it is made from_______ and comes as ______units. |
|
Definition
|
|
Term
| when days were dark and vetsulin was unavailable - what was the next best choice for insulin for diabetic dogs? |
|
Definition
|
|
Term
| This CRH acts by decreasing peripheral use of glucose while increasing breakdown of fats and aa's |
|
Definition
|
|
Term
| This CRH is produced by anterior pituitary |
|
Definition
|
|
Term
| Term for body's response to low blood glucose with CRH's causing a compensatory glucose spike |
|
Definition
|
|
Term
| Infection of what specific organism can cause hypoglycemia? |
|
Definition
|
|
Term
| Fructosamine gives an average glucose level over the past _____ weeks. |
|
Definition
|
|
Term
| Remember megaesophagus caused by _____ is reversible, but when cause by ___ is NOT! |
|
Definition
| Addison's: Hypothyroidism |
|
|
Term
| This drug is used to replace the mineralcoricoid loss in typical Addison's patients |
|
Definition
| Desoxycorticosterone pivalate (DOCP) |
|
|
Term
|
Definition
| Hyperparathyroid; Osteomyelitis; Granulomatous; Spurious; Idiopathic cats; Neoplasia; Young; Addison's; Renal; D Hypervitamin |
|
|
Term
| Most common cause of Hypercalcemia in a dog |
|
Definition
|
|
Term
| Even though lymphoma is the number one cause of hypercalcemia in a dog; how many of lymphoma cases are actually hypercalcemic?? |
|
Definition
|
|
Term
| If an animal licks an owners Dovonex cream... what will happen to it? |
|
Definition
|
|
