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55 Cards in this Set
- Front
- Back
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Which substances are involved in the regulation of Ca and P? What does each do?
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Parathyroid Hormone (resorbs Ca and P from bone and gut ; reduces Ca excretion and increases P excretion);
Calcitonin (decreases serum Ca and inhibits PTH action); Vit D (increases Ca and P conc) |
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How can lymphoma impact Ca levels?
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Lymphoma can produce PTH related protein, increasing serum Ca
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What are the three Ca fractions evaluated in the lab? What fractional % does each comprise?
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Free ionized Ca (50%);
Protein bound Ca (40-45%; Complexed Ca (5-10%) |
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Which calcium fraction is regulated by the body?
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Free ionized Ca.
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T or F:
Paraneoplastic effects are rarely produced in lymphomas and anal sac adenomas. |
False!
They are rare with lymphomas but often produced with anal sac adenomas (although anal sac adenomas themselves are rare). |
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What variables are necessary in order to calculate the corrected total calcium? When is this value useful?
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Need measured Ca and albumin concentration. Useful with hypoalbuminemic dogs.
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Do your best to name all the major causes of hyercalcemia....ready.....................wait for it...........GO!!!!
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Primary hyperparathyroidism
Paraneoplastic hyperparathyroidism Renal failure (horses) Hypoadrenocorticism Hypervitaminosis D other rare stuff (osteolytic lesions, laying hens, granulomatous dz) |
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T or F:
[PTH] is usually high in hyperparathyroidism. |
False!
PTHrp can be the cause (hyperneoplastic effect) |
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How can paraneoplastic hypercalcemia be diagnosed through blood chemistries?
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Measure PTH-rP
Also normal PTH would be ZERO |
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T or F:
Renal failure is a common cause of hypocalcemia in all domestic species. |
False! Not in horses...renal failure causes HYPERcalcemia in horses!
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Will ionized Ca be low, normal, or high in hypoadrenocorticism?
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Normal!
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What are some causes of HYPOcalcemia?
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Hypoalbuminemia
Renal secondary hyperparathyroidism Pregnancy/lactation Hypomagnesemic tetany Nutrition |
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What is the most common cause of hypocalcemia in domestic species?
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Hypoalbuminemia
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How can Mg affect Ca levels?
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Low Mg causes reduced PTH --> low Ca
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Which components of the diet must be out of balance in order to cause nutritional secondary hyperparathyroidism?
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Low Ca and/or high P
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What hormone shifts PO4 into cells?
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Insulin
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How is phosphate excreted in most domestic species? How about in ruminants?
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Kidneys (GI in ruminants)
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What are some causes of hyperphosphatemia?
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Renal failure;
Hypoparathyroidism; increased absorption; Cellular release (lysis & etc); Bone growth |
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What are some causes of hypophosphatemia?
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Hyperinsulinism
Equine renal failure Decreased absorption RARE CONDITION |
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What two biological processes regulate Mg?
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Intestinal absorption and renal excretion
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Predict the levels of K, Mg, and Ca in an animal with grass tetany?
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HYPERkalemia
HYPOmagnesemia HYPOcalcemia |
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What is the best test for hypothyroidism?
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Free T4 by equilibrium dialysis
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The combination of which two parameters is the most diagnostic of hypothyroidism?
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Low free T4 and high TSH
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Which of the following tests can be affected by autoantibodies?
a) T4 b) free T4 c) T3 d) Thyroglobulin |
All but free T4
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What are the three thyroid function tests? Which isn't used much?
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TSH stimulation test;
TRH stimulation test (uncommon); T3 suppression |
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Which test is the gold standard for canine hypothyroidism?
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TSH stim test
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When is T3 suppression used? How is this test carried out?
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T3 suppression used in cats if total T4 is inconclusive for hypothyroidism.
Take baseline T4, give oral T3 for 2 days then take 2nd sample on 3rd day. Normal cats suppress <1.5mg/dl |
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Which tests are used to detect hypothyroidism?
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Total T4;
Free T4 by equilibrium dialysis; Endogenous TSH |
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What are differentials for a low total T4 in a dog?
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Hypothyroid;
Enthyroid sick syndrome; iatrogenic (drugs) |
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T or F:
Hyperthyroid cats generally have bilateral thyroid hyperplasia. |
True
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What are some common lab abnormalities in a hyperthyroid cat?
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Mild PCV increase
Mild ALT increase Total T4 increased maybe hyperphosphatemia |
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Which hormones are produced by the pancreas?
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Insulin
Glucagon SST |
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What is the most important measurement for endocrine pancreatic assessment?
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Blood glucose
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Choose D. Mellitus type I or II...
...mostly in dogs. |
Type I
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Choose D. Mellitus type I or II...
...immune mediated. |
Type I
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Choose D. Mellitus type I or II...
...mostly in cats. |
Type II
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Choose D. Mellitus type I or II...
...associated with amyloid deposits in pancreas. |
Type II
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What are the functions of cortisol?
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Gluconeogenesis
Insulin antagonist INcrease lipolysis Immunosuppression |
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What is aldosterone regulated by?
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Serum [K];
Renin-angiotensin |
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What hormone is responsible for Na resorption and K excretion?
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Aldosterone
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What lab tests assay adrenal function?
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Plasma cortisol
ACTH stim test LDDS (low-dose dexamethosone suppression) HDDS (high-dose dex sup) Endogenous ACTH assay |
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How is plasma cortisol measured?
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immunoassay
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Which test is THE test for hypoadrenocorticism?
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ACTH stim test
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Predict the results of an ACTH stim test for a Cushingoid dog? A dog with Addison's?
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Cushingoid (>20ug/dl)
Addison's (no response) |
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T or F:
ACTH stim can be used to diagnose hypo or hyperadrenocorticism. |
True!
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What effect does dexamethasone have on cortisol in normal animals?
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Suppresses cortisol levels
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T or F:
HDDS can be used for hyperadrenocorticism screening in cats, dogs, and horses. |
False!
THis describes LDDS |
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What is the HDDS test used for? How is it interpreted?
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To distinguish a pituitary from an adrenal tumor in hyperadrenocorticsm. Non-suppressive cortisol levels = adrenal tumor.
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Which test can reliably distinguish an adrenal from a pituitary tumor in hyperadrenocorticism? How is this interpreted?
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Endogenous plasma ACTH assay is high in pituitary tumors, low in adrenal.
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What are the 3 types of hyperadrenocorticism? Which is most common?
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PItuitary-derived (most common)
Adrenal-derived Iatrogenic |
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What is different about equine Cushings as compared to other domestic animals?
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Functional adenoma of the pars intermedia of the pituitary gland
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How is equine cushing's diagnosed?
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overnight HDDS
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What is the "ferret panel" for hyperadrenocorticism? How is this panel interpreted?
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Estradiol
Androstenedione 17-OH-progesterone (all will be high in adrenal dz) |
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What Na:K ratios are suggestive of addison's dz?
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<23:1 very suggestive
<26:1 somewhat suggestive |
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What is a major cause of hypoadrenocorticism in dogs?
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Immune-mediated (suspected);
also iatrogenic |
