Endocrinology Test #1 All Quiz Questions Plus Pu/pd Mechanisms

Front 1

What test would you use to definitively diagnose Addison's?

Back 1

ACTH Stim

Front 2

Cushing's can be caused by which of the following?

Back 2

Adrenal neoplasia
Exogenous Steroid
Thyroid neoplasia

Hint 2

The first two.

Front 3

Name the 4 hallmarks of DKA

Back 3

ketonuria
Hyperglycemia
Glucosuria
Met. Acidosis

Front 4

What system is most affected by systemic hypoglycemia?

Back 4

CNS

Front 5

The primary goal in treating an Addisonian crisis is…

Back 5

Restore blood volume (fluids)

Front 6

Addison’s has a good long-term prognosis with which treatment protocol?

Back 6

Monthly DOCP and daily prednisone

Front 7

Name the glucose counter regulatory hormones and what speed of control is associated with each.

Back 7

-Glucagon (fast), epinephrine (fast), cortisol (slow), Growth Hormone (slow)

Front 8

PTH directly causes what?

Back 8

Reabsorption of Ca & PO4 from bone.
Excretion of PO4 and Retention of Ca in the Kidney

Front 9

Renal alpha hydroxylase is mediated by

Back 9

Calcitonin, PTH, phosphorus, calcium, and calcitriol

Front 10

Which is the most common cause of HHM in a cat?

Back 10

Lymphoma

Front 11

Which is the most common cause of HHM in a cat that is UNCOMMON in dogs?

Back 11

Squamous Cell carcinoma

Front 12

Which is the most important hormone in the pathogenesis of DKA

Back 12

Glucagon

Front 13

Increased serum osmolarity in a dog would trigger what?

Back 13

PD. Increased ADH. RAAS. Take your pick.

Front 14

Name a test you needn't ever do in a dog.

Back 14

fT4

Front 15

Bam Bam, a 8 year-old FS Maltese, is presented on emergency for anorexia, vomiting ad weakness. On her electrolyte panel performed in ICU, you note a low ionized calcium of 1.02 (1.26 - 1.39). You receive the following results back on Bam Bam's biochemical profile:
tCa 12.2 mg/dL (9.9-11.5)
PO4 5.2 mg/dL (2.2-4.6)
You also note azotemia. Which of the following disease processes is MOST likely the cause of Bam Bam's clinical signs and the azotemia?

Back 15

Chronic kidney disease, IRIS stage 4

Front 16

Bogey, a 14 year-old MC Dachshund mix with diabetes, is presented for anorexia, vomiting, and listlessness. He is pretty dehydrated on examination and has a painful abdomen. Based on appropriate testing, you diagnose him with diabetic ketoacidosis. Unfortunately, it is one of 'those' days and you are going into surgery to correct an abdominal dehiscence.

You instruct the technician to place an intravenous catheter and begin Bogey on aggressive fluid therapy, based on his current level of dehydration and expected ongoing losses. The technician is pretty surprised you are not starting Bogey on insulin because his glucose is 894 mg/dL.

What do you tell her?

Back 16

The glucose should come way down as fluid therapy expands the intravascular volume and restores GFR. If we add insulin at the same time, we risk dropping the osmolarity too fast and causing cerebral edema.

Front 17

You have recently diagnosed Sally Savoie, an 8 year-old FS Pit Bull, with photosensitive dermatitis - a inflammatory condition of the skin that is exacerbated by sun-exposure. You explain to the owner that Sally will need to be kept out of the sun as much as possible.

Ms. Savoie is very concerned that the sun restriction may cause Sally to become deficient in vitamin D. What do you tell her?

Back 17

Light restriction should not be a problem for Sally. Dogs get their vitamin D primarily from dietary intake, instead of synthesizing it in response to sunlight.

Front 18

Brenna, a 6 year-old FS German shepherd dog, is presented for further evaluation of restlessness and tremors. On examination, you note hyperthermia and rapid worsening of tremors while the technicians are placing an intravenous catheter. You run a stat electrolyte panel and discover severe ionized hypocalcemia.


In nervousness, you accidentally drop and break (doh!) the only bottle of calcium gluconate in the clinic. You do find a bottle of calcium chloride on the shelf. The technician offers to drive to a nearby clinic to get a bottle of calcium gluconate.

What do you do and why?

Back 18

Check the catheter and administer calcium chloride slowly, because there is not time to wait for the technician to go and return.

Front 19

Brutus, a 5 year old MC German Shepherd dog, is presented for evaluation of episodic muscle tremors. The owner reports episodes occur most commonly when he is running around at the dog park.

Which of the following would be most consistent with a diagnosis of hypoparathyroidism?

Back 19

Decreased total calcium, increased phosphorus, decreased ionized calcium, decreased PTH

Front 20

Mindy, a 6 year-old FS Keeshond, is presented for evaluation of PUPD and, after work-up, you diagnose her with hyperparathyroidism. On cervical explore, you note one enlarged parathyroid gland and remove it without incident.

Two days post-operatively, Mindy begins to have mild muscle fasciculations in her cage. You recheck blood work and discover Mindy has become hypocalcemic.

What is the most likely explanation?

Back 20

Mindy's chronic marked hypercalcemia has resulted in atrophy of her normal parathyroid glands. Until they return to normal function, Mindy will need calcium and vitamin D supplementation.

Front 21

Shadow, a 7 year old MC mixed breed dog is presented for evaluation of malaise and increased urination. On labwork, the total calcium is 21 mg/dl (9.9-11.5).

What is the most likely differential for the hypercalcemia?

Back 21

Cancer

Front 22

Ashton, a 14 year-old FS DLH Tortiseshell, is presented to you for increased water intake and recurrent constipation. The following abnormalities are present on blood work:
BUN 53 mg/dl (9-24)
Cr 2.6 mg/dL (0.6-1.6)
PO4 6.0 mg/dL (2.2-4.6)
tCa 13.1 mg/dl (9.9-11.5)
iCa 1.0 mmol/L (1.2-1.47)
PTH 6 pmol/l (2-13)

Which of the following is MOST likely?

Back 22

Chronic kidney disease with secondary hypercalcemia

Front 23

Mack is a 5 month-old MI Golden retriever. He was dropped off for neuter before you got to work, so you do not have any history on him yet. His owners did authorize pre-anesthetic blood work.

Your technician comes to you, concerned because Mack's calcium is increased on his biochemical profile.

Would you be concerned about an ALP rise?

Back 23

Nah. He's a puppy. He's prolly just been rough housing.

Front 24

Lucy, a 2 year-old FI chihuahua, is presented to you for acute restlessness and panting. She whelped her first litter 1 week ago. You diagnose Lucy with eclampsia and stabilize her with intravenous calcium gluconate.

The owner had been supplementing Lucy with oral calcium prior to whelp and wants to know whether the pet store sold her 'bad' pills. What do you tell her?

Back 24

The pills were not 'bad'. Calcium supplementation increases the risk of eclampsia because higher circulating calcium levels decrease parathyroid gland stimulation and compromise their ability to respond to the sharply increased demands of lactation.

Front 25

What tests would you run to rule out the most common causes of PU/PD in a dog?

Back 25

CBC
Chem
Lytes
UA

Say all those are normal and they can still concentrate urine. What would you diagnose?
Uculture
Abdominal ultrasound
ACTH Stim

Hint 25

Primary PD

Front 26

How does Acromegaly cause PU/PD?

Back 26

Osmostic diuresis.

What's the classificaton?

Hint 26

PU due to 2ndary NDI

Front 27

How does CDI cause PU/PD?

Back 27

ADH deficiency. One would think Osmotic diuresis, but one would be wrong.

Front 28

How does Chronic partial ureteral obstruction cause PU/PD?

Back 28

Downregulation of aquaporin-2.

Front 29

How does CRF cause PU/PD?

Back 29

Osmotic Diuresis; impaired countercurrent mechanism.

Front 30

How does DM cause PU/PD?

Back 30

Osmotic diuresis

Front 31

How does Fanconi Syndrome cause PU/PD?

Back 31

Osmotic diuresis

Front 32

How does HAC cause PU/PD?

Back 32

Impaired release of ADH (CDI)
Impaired response to ADH (NDI)
Psychogenic PD

Front 33

How does Hypercalcemia cause PU/PD?

Back 33

Interferes with action of ADH on renal tubule

Front 34

How does HoAC cause PU/PD?

Back 34

Loss of medullary hypertonicity

Front 35

How does Hypokalemia cause PU/PD?

Back 35

downregulation of aquaporin-2; loss of medullary hypertonicity

Front 36

How does Hyponatremia cause PU/PD?

Back 36

Loss of medullary hypertonicity

Front 37

How does Leiomyosarcoma cause PU/PD?

Back 37

Impaired tubular response to ADH

Front 38

How does Leptospirosis cause PU/PD?

Back 38

CRF

Front 39

How does Liver Failure cause PU/PD?

Back 39

Loss of medullary hypertonicity; impaired hormone metabolism

Front 40

How does Pheochromocytoma cause PU/PD?

Back 40

Excessive catecholamines

Front 41

How does Polycythemia cause PU/PD?

Back 41

Impaired release of ADH (CDI); works on Atrial natriuretic peptide (NDI)

Front 42

How does Polyuric ARF cause PU/PD?

Back 42

Osmotic diuresis

Front 43

How does PSS cause PU/PD?

Back 43

loss of medullary hypertonicity; increased GFR; psychogenic PD

Front 44

How does Post-obstructive diuresis cause PU/PD?

Back 44

Osmotic diuresis; down-regulation of aquaporin-2

Front 45

How does Hyperaldosteronism cause PU/PD?

Back 45

Impaired release of ADH (CDI); impaired response to ADH (NDI)

Front 46

How does NDI cause PU/PD?

Back 46

Congenital inability of nephron to respond to ADH

Front 47

How does Primary PD cause PU/PD?

Back 47

Psychogenic PD, hepatic encephalopathy, hyperthyroidism, GI disease

Front 48

How does Primary renal glycosuria cause PU/PD?

Back 48

Osmotic diuresis

Front 49

How does Pyelonephritis cause PU/PD?

Back 49

Bacterial endotoxin reduces tubular sensitivity to ADH; damaged countercurrent mechanism

Front 50

How does Pyometra cause PU/PD?

Back 50

Bacterial endotoxin reduces tubular sensitivity to ADH

Front 51

How does Renal medullary solute washout cause PU/PD?

Back 51

Decreased renal medullary tonicity with loss of osmotic gradient

Front 52

How does Splenomegaly cause PU/PD?

Back 52

Psychogenic PD

Front 53

What things can cause a primary PD?

Back 53

Splenomegaly, PD, Liver Failure, Hyperthyroidism, HAC

Front 54

What causes of PU/PD are related to ADH?

Back 54

Acromegaly
CDI
HAC
Hypercalcemia
Leiomyosarcoma
Polycthemia
Hyperaldosteronism
Primary NDI
Pyelonephritis
Pyometra

Front 55

What causes of PU/PD are related to aquaporin-2

Back 55

Ureteral Obstruction
Hypokalemia
Post-obstructive diuresis

Front 56

Name all the causes of PU/PD that are related to medullary tonicity

Back 56

Hyperthyroid
HoAC
Hypokalemia
HypoNa
Liver Failure
PSS
Medullary Washout

Front 57

Name all the causes of PU/PD that are related to Osmotic Diuresis

Back 57

Acromegaly
CRF
DM
Fanconi
ARF
Post-obstructive diuresis
Primary renal glycosuria