Shared Flashcard Set

Details

Exam 3
Hyperthyroidism
26
Veterinary Medicine
Professional
10/27/2016

Additional Veterinary Medicine Flashcards

 


 

Cards

Term
Where does primary hyperthyroidism occur?
Definition
-the thyroid gland
Term
Roughly what percentage of primary thyroid disease is benign? Give some examples.
Definition
->98%
-adenomatous hyperplasia
-adenoma
Term
Roughly what percentage of primary thyroid disease is malignant? Give some examples?
Definition
-<2% malignant
-adenocarcinoma
Term
What it the typical signalment of hyperthyroidism?
Definition
-older: average age 12-13y
-no sed or breed predilections
Term
What are the clinical signs of hyperthyroidism from most to least common?
Definition
-weight loss
-polyphagia
-hyperactivity
-PU/PD
-vomiting
-diarrhea
-panting
-weakness
Term
Roughly what percentage of cats with hyperthyroidism have apathetic hyperthyroidism? WHat are the clinical signs?
Definition
-<10%
-anorexia and lethargy
Term
What is the clinical significance of apatehtic hyperthyroidism?
Definition
-search for concurrent illness: CHF and neoplasia
Term
What signs do we see on physical exam with cats with hyperthyroidism?
Definition
-poor body condition
-unkept hair coat
-agitated
0thyroid slip (>80%), not specific
=CV: mimics HCM, tachycardia, gallop rhythm, murmur
-tachypneic
Term
What do we see on CBC with hyperthyroid cat?
Definition
-BCT high in cat > 12y
-stress leukogram
Term
What do we see on biochem analysis with a hyperthyroid cat?
Definition
-elevated liver enzymes with normal serum bilirubin
-hyperglycemia: stress-induced
-inc BUN:Creatinie ration (inc dietary protein and dec muscle mass)
-hypocholesterolemia: lipid metabolism
Term
What do we see on UA with hyperthyroidism?
Definition
-DIlute urine (USG < 1.035)
-proteinuria
022% have bacterial UTI
Term
What other diagnostic tests and their results do we see with hyperthyroidism?
Definition
-urine culture
-BP
-/+ thoracic rads: signs of resp dz or dyspnea
-/+ echocardiogram: heart murmur, gallop rhythm, signs of CHF
-abdominal US: not routinely recommend
Term
How do we definitively diagnose thyroidism?
Definition
-strong clinical suspicion: clinical findings
-Total T4
Term
If you see clinical signs that suggest hyperthyroidism but your TT4 is on the upper end of normal what do you do?
Definition
-retest in 1-3m
-free T4
-Technetium scan
-T3 suppression test
-Trial treatment
Term
What results do we expect on a Technetium scan with hyperthyroidism?
Definition
-uptake of thyroid gland should be higher than salivary glands
Term
HOw do we perform a technetium scan?
Definition
-administer IV and scam with a gamma camera
Term
How do we perfomr a T3 suppression test? What are our normal results? What are our hyperthyroidism results?
Definition
-measure T4, administer T3, then measure T4 & T3
-normal = suppression
-HyperT = fails to suppress
Term
How do we treat hyperthyroidism?
Definition
-thioureylene antihyroid drugs: Methimazole or carbimazole
-radioactive iodine
-surgical thyroidectomy: only with adenocarcinoma
Term
How does Methimazole work? Dose? When do we recheck it?
Definition
-inhibits iodide incorporation
-2.5 mg PO BID (better) or 5 mg/kg SID
-recheck T4 2-3w until euthyroid & inc dose 25-50% until euthyroid
Term
What are the side effects of Methimazole?
Definition
-vomiting/diarrhea/anorexia: most common
-hepatopathy
-bone marrow suppression
-facial excoriation
Term
How do we monitor Methimazole? What do we do if we have severe GI side effects? What do we do if we have other side effects?
Definition
-CBC and biochem q2-3w initially
-trandermal formulation
-Discontinue drug
Term
How does radioactive iodine (I131) treat hyperthyroidism? How is it administered?
Definition
-destroys tissue within 2mm distance
-administered SQ
Term
How well does I131 treatment work for hyperthyroidism? What are its downsides?
Definition
->90% work
-requires special facilities, specieal training, isolation for 1w, larger cost, and permanent
Term
What are the major downsides to iodine restricted diet (Hill's Y/D) to treat hyperthyroidism?
Definition
-cannot eat any other food or treats
-takes long time to achieve euthyroid
-may not alleviate clinical signs
Term
Is thyroidectomy appropriate for routine hyperthyroid treatment? If not, when do we use it?
Definition
-NO
-reserved for thyroid carcinoma
Term
What are the common complications seen with thyroidectomy?
Definition
-hypoparathyroidism
-hemorrhage
-laryngeal paralysis
-Horner's syndrome
Supporting users have an ad free experience!