Podcast
Questions and Answers
Which of the following glands are considered endocrine glands?
Which of the following glands are considered endocrine glands?
Hormones can only affect their corresponding target organs through direct interaction with the bloodstream.
Hormones can only affect their corresponding target organs through direct interaction with the bloodstream.
False
What is the main function of trophic hormones?
What is the main function of trophic hormones?
To regulate the secretion of other hormones.
In type II diabetes, the down regulation of _____ receptors leads to insulin resistance.
In type II diabetes, the down regulation of _____ receptors leads to insulin resistance.
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Match the following conditions with their associated gland:
Match the following conditions with their associated gland:
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What is the effect of reduced secretion of a trophic hormone?
What is the effect of reduced secretion of a trophic hormone?
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Endocrine diseases often result from the balanced secretion of hormones.
Endocrine diseases often result from the balanced secretion of hormones.
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What is the consequence of receptor failure on a target organ's response to its hormone?
What is the consequence of receptor failure on a target organ's response to its hormone?
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What is the primary effect of hyperplasia or neoplasia of an endocrine gland?
What is the primary effect of hyperplasia or neoplasia of an endocrine gland?
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The posterior pituitary is primarily responsible for hormone production.
The posterior pituitary is primarily responsible for hormone production.
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What hormone is primarily inhibited by dopamine secretion from the hypothalamus?
What hormone is primarily inhibited by dopamine secretion from the hypothalamus?
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Increased secretion of parathyroid hormone-related protein (PTHrp) can result in higher levels of serum ______.
Increased secretion of parathyroid hormone-related protein (PTHrp) can result in higher levels of serum ______.
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Match the following hormones with their corresponding functions:
Match the following hormones with their corresponding functions:
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Which of the following conditions is a common cause of hyperparathyroidism due to renal dysfunction?
Which of the following conditions is a common cause of hyperparathyroidism due to renal dysfunction?
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Negative feedback mechanisms help maintain hormone concentrations within a wide physiological range.
Negative feedback mechanisms help maintain hormone concentrations within a wide physiological range.
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What is the condition called when prolonged use of prednisone leads to signs of hyperadrenocorticism?
What is the condition called when prolonged use of prednisone leads to signs of hyperadrenocorticism?
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The anterior pituitary is derived from tissue related to the fetal ______.
The anterior pituitary is derived from tissue related to the fetal ______.
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Match the type of tumor with the hormone-like substance it may produce:
Match the type of tumor with the hormone-like substance it may produce:
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What is a common clinical sign of PPID in horses?
What is a common clinical sign of PPID in horses?
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Horses with PPID frequently show increased responsiveness to pain stimuli.
Horses with PPID frequently show increased responsiveness to pain stimuli.
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What is the main role of cortisol in the body?
What is the main role of cortisol in the body?
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In the case of adrenal tumors, cortisol production remains uninhibited despite high levels of ACTH.
In the case of adrenal tumors, cortisol production remains uninhibited despite high levels of ACTH.
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What is the preferred testing method for diagnosing PPID in horses during autumn?
What is the preferred testing method for diagnosing PPID in horses during autumn?
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Which horses are typically predisposed to Pituitary pars intermedia dysfunction (PPID)?
Which horses are typically predisposed to Pituitary pars intermedia dysfunction (PPID)?
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Horses with PPID may develop ________, resulting from the expansion of adenomas into the hypothalamus.
Horses with PPID may develop ________, resulting from the expansion of adenomas into the hypothalamus.
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The ______ is responsible for synthesizing oxytocin and ADH.
The ______ is responsible for synthesizing oxytocin and ADH.
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Match the following clinical signs with their descriptions:
Match the following clinical signs with their descriptions:
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What factor is NOT associated with the development of neurodegeneration in aging horses?
What factor is NOT associated with the development of neurodegeneration in aging horses?
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PPID in horses is referred to as equine Cushing’s disease.
PPID in horses is referred to as equine Cushing’s disease.
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What may lead to a presumptive diagnosis of PPID in older horses?
What may lead to a presumptive diagnosis of PPID in older horses?
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The _______ test was previously considered the gold standard for diagnosing PPID but is no longer recommended with the availability of ACTH testing.
The _______ test was previously considered the gold standard for diagnosing PPID but is no longer recommended with the availability of ACTH testing.
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What is a consequence of chronic elevation of ACTH in horses?
What is a consequence of chronic elevation of ACTH in horses?
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Mild to moderate hyperglycaemia may be present in horses with PPID.
Mild to moderate hyperglycaemia may be present in horses with PPID.
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What clinical sign involves abnormal fat distribution around the eyes in horses with PPID?
What clinical sign involves abnormal fat distribution around the eyes in horses with PPID?
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An _______ leukogram may be observed in horses with PPID.
An _______ leukogram may be observed in horses with PPID.
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Which of the following is NOT a common clinical sign of PPID?
Which of the following is NOT a common clinical sign of PPID?
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What condition is commonly associated with poorly controlled diabetes mellitus in cats?
What condition is commonly associated with poorly controlled diabetes mellitus in cats?
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Affected cats with acromegaly usually lose weight.
Affected cats with acromegaly usually lose weight.
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Name one common clinical sign of acromegaly in cats.
Name one common clinical sign of acromegaly in cats.
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Acromegaly is caused by an overproduction of __________ hormone.
Acromegaly is caused by an overproduction of __________ hormone.
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Match the following components of the adrenal gland with their functions:
Match the following components of the adrenal gland with their functions:
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What is the suggested IGF-1 level indicative of acromegaly?
What is the suggested IGF-1 level indicative of acromegaly?
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Intracranial imaging is commonly used for diagnosing acromegaly.
Intracranial imaging is commonly used for diagnosing acromegaly.
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What is the major regulator of cortisol production in the adrenal cortex?
What is the major regulator of cortisol production in the adrenal cortex?
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The normal cortex:medulla ratio in the adrenal gland is approximately __________.
The normal cortex:medulla ratio in the adrenal gland is approximately __________.
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Which of the following describes the most common cause of secondary hyperadrenocorticism in dogs?
Which of the following describes the most common cause of secondary hyperadrenocorticism in dogs?
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Hyperadrenocorticism in dogs can occur due to iatrogenic causes.
Hyperadrenocorticism in dogs can occur due to iatrogenic causes.
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What type of adrenal tumor is typically well-demarcated and surrounded by a fibrous capsule?
What type of adrenal tumor is typically well-demarcated and surrounded by a fibrous capsule?
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The adrenal cortex is divided into three zones: zona glomerulosa, zona fasciculata, and zona __________.
The adrenal cortex is divided into three zones: zona glomerulosa, zona fasciculata, and zona __________.
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Match the following types of Cushing's syndrome with their definitions:
Match the following types of Cushing's syndrome with their definitions:
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Which clinical sign is NOT associated with Cushing’s syndrome in dogs?
Which clinical sign is NOT associated with Cushing’s syndrome in dogs?
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Leukocytosis with lymphopenia is not a typical finding in Cushing's syndrome.
Leukocytosis with lymphopenia is not a typical finding in Cushing's syndrome.
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What is the main biochemical marker that can indicate hyperadrenocorticism in dogs?
What is the main biochemical marker that can indicate hyperadrenocorticism in dogs?
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The urinary cortisol:creatinine ratio is useful for ruling out a diagnosis of _____________ disease.
The urinary cortisol:creatinine ratio is useful for ruling out a diagnosis of _____________ disease.
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What effect do glucocorticoids have on glucose levels?
What effect do glucocorticoids have on glucose levels?
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A small dose of dexamethasone suppresses ACTH release in normal dogs.
A small dose of dexamethasone suppresses ACTH release in normal dogs.
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What is the preferred method to collect urine for the urinary cortisol:creatinine ratio test?
What is the preferred method to collect urine for the urinary cortisol:creatinine ratio test?
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Neutrophilia and monocytosis in dogs with Cushing's are due to reduced _____________ and emigration of cells.
Neutrophilia and monocytosis in dogs with Cushing's are due to reduced _____________ and emigration of cells.
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Match the following tests with their descriptions:
Match the following tests with their descriptions:
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Which of the following is a common clinical sign in dogs with Cushing's syndrome?
Which of the following is a common clinical sign in dogs with Cushing's syndrome?
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An increased serum basal cortisol concentration is definitive evidence of hyperadrenocorticism.
An increased serum basal cortisol concentration is definitive evidence of hyperadrenocorticism.
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What concurrent disease condition may suggest a diagnosis of Cushing’s in diabetic dogs?
What concurrent disease condition may suggest a diagnosis of Cushing’s in diabetic dogs?
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Calcinosis cutis commonly occurs in about _____________ percent of dogs with Cushing's syndrome.
Calcinosis cutis commonly occurs in about _____________ percent of dogs with Cushing's syndrome.
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Which of the following is a frequent complication of Cushing’s syndrome in dogs?
Which of the following is a frequent complication of Cushing’s syndrome in dogs?
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What is the primary substance administered during the ACTH stimulation test?
What is the primary substance administered during the ACTH stimulation test?
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Hyperplastic adrenal glands will under-respond to the administration of ACTH.
Hyperplastic adrenal glands will under-respond to the administration of ACTH.
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What is the expected response of a normal dog to a high dose dexamethasone suppression test?
What is the expected response of a normal dog to a high dose dexamethasone suppression test?
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Dogs with __________ have low plasma ACTH concentrations due to negative feedback from excessive cortisol.
Dogs with __________ have low plasma ACTH concentrations due to negative feedback from excessive cortisol.
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When using the ACTH stimulation test, which animal condition has the lowest sensitivity for diagnosis?
When using the ACTH stimulation test, which animal condition has the lowest sensitivity for diagnosis?
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What percentage of cats show suppression at 4 hours in the LDDST?
What percentage of cats show suppression at 4 hours in the LDDST?
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Match the following adrenal conditions to their corresponding test outcome:
Match the following adrenal conditions to their corresponding test outcome:
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Feline hyperadrenocorticism primarily results from adrenal tumors.
Feline hyperadrenocorticism primarily results from adrenal tumors.
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What must be known before measuring ACTH to confirm hyperadrenocorticism?
What must be known before measuring ACTH to confirm hyperadrenocorticism?
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Urine cortisol to creatinine ratio is a useful screening test due to its __________ sensitivity but low specificity.
Urine cortisol to creatinine ratio is a useful screening test due to its __________ sensitivity but low specificity.
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Which clinical sign is reported in 81% of cats with hyperadrenocorticism?
Which clinical sign is reported in 81% of cats with hyperadrenocorticism?
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In dogs with PDH, adrenal glands are typically __________.
In dogs with PDH, adrenal glands are typically __________.
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What laboratory abnormality is most commonly found in cats with hyperadrenocorticism?
What laboratory abnormality is most commonly found in cats with hyperadrenocorticism?
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ACTH measurement is currently available in New Zealand.
ACTH measurement is currently available in New Zealand.
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What is hyperlipidaemia defined as?
What is hyperlipidaemia defined as?
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Lipoproteins are named for their size rather than their density.
Lipoproteins are named for their size rather than their density.
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What is the primary organ responsible for cholesterol synthesis?
What is the primary organ responsible for cholesterol synthesis?
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Endothelial cells in tissues such as adipose and muscle have an enzyme called __________ that breaks down lipid/lipoprotein complexes.
Endothelial cells in tissues such as adipose and muscle have an enzyme called __________ that breaks down lipid/lipoprotein complexes.
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Match the following conditions with their associated causes:
Match the following conditions with their associated causes:
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What is the primary cause of clinical signs of functional phaeochromocytoma in affected animals?
What is the primary cause of clinical signs of functional phaeochromocytoma in affected animals?
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What can cause the plasma to appear lipaemic?
What can cause the plasma to appear lipaemic?
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Benign neoplasms such as phaeochromocytomas have a recurrence rate of up to 15% after surgical excision.
Benign neoplasms such as phaeochromocytomas have a recurrence rate of up to 15% after surgical excision.
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Anorexia can lead to hyperlipidaemia in horses.
Anorexia can lead to hyperlipidaemia in horses.
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What clinical condition results from aldosterone deficiency due to hypoadrenocorticism?
What clinical condition results from aldosterone deficiency due to hypoadrenocorticism?
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What is the primary production difference between T3 and T4?
What is the primary production difference between T3 and T4?
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In hypoadrenocorticism, a Na:K ratio of less than _____ is highly suggestive of the condition.
In hypoadrenocorticism, a Na:K ratio of less than _____ is highly suggestive of the condition.
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A lipoprotein that is primarily involved in transporting cholesterol is __________.
A lipoprotein that is primarily involved in transporting cholesterol is __________.
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Which of the following conditions is linked to decreased biliary excretion of cholesterol?
Which of the following conditions is linked to decreased biliary excretion of cholesterol?
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Match the clinical signs with the condition they are associated with:
Match the clinical signs with the condition they are associated with:
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What electrolyte abnormality is commonly observed in hypoadrenocorticism?
What electrolyte abnormality is commonly observed in hypoadrenocorticism?
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Cholesterol is only acquired through dietary sources in omnivores.
Cholesterol is only acquired through dietary sources in omnivores.
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What role does thyroglobulin play in thyroid hormone synthesis?
What role does thyroglobulin play in thyroid hormone synthesis?
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Malignant phaeochromocytomas never result in metastasis.
Malignant phaeochromocytomas never result in metastasis.
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High-density lipoproteins (HDL) are often referred to as __________ lipoproteins.
High-density lipoproteins (HDL) are often referred to as __________ lipoproteins.
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What diagnostic test is definitive for confirming hypoadrenocorticism?
What diagnostic test is definitive for confirming hypoadrenocorticism?
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Adrenocortical atrophy can lead to deficiency in _____, glucocorticoids, and adrenal sex steroids.
Adrenocortical atrophy can lead to deficiency in _____, glucocorticoids, and adrenal sex steroids.
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Match the following lipoproteins with their characteristic:
Match the following lipoproteins with their characteristic:
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What is the most likely cause of idiopathic adrenal atrophy in dogs?
What is the most likely cause of idiopathic adrenal atrophy in dogs?
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Most phaeochromocytomas in animals are functional and secreting adrenaline.
Most phaeochromocytomas in animals are functional and secreting adrenaline.
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What are common clinical signs of atypical Addison’s disease?
What are common clinical signs of atypical Addison’s disease?
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Nodular cortical hyperplasia is a common incidental finding in adrenal glands of _____ dogs.
Nodular cortical hyperplasia is a common incidental finding in adrenal glands of _____ dogs.
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What is the significance of a 'non-stress' leukogram in the haematology of hypoadrenocorticism?
What is the significance of a 'non-stress' leukogram in the haematology of hypoadrenocorticism?
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What is the most common cause of goitre in livestock?
What is the most common cause of goitre in livestock?
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Hyperthyroidism is primarily associated with an increase in T4 and T3 levels.
Hyperthyroidism is primarily associated with an increase in T4 and T3 levels.
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What substance is primarily affected by T3 administration in healthy cats during the T3 suppression test?
What substance is primarily affected by T3 administration in healthy cats during the T3 suppression test?
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What are two useful timepoints for monitoring treatment responses in dogs with hypothyroidism?
What are two useful timepoints for monitoring treatment responses in dogs with hypothyroidism?
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Elevated free T4 levels are definitive evidence of hyperthyroidism in cats.
Elevated free T4 levels are definitive evidence of hyperthyroidism in cats.
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What is the primary function of T3 in the body?
What is the primary function of T3 in the body?
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Iodine deficiency may cause a non-neoplastic enlargement of the thyroid known as __________.
Iodine deficiency may cause a non-neoplastic enlargement of the thyroid known as __________.
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Name a common illness that can suppress T4 levels in cats.
Name a common illness that can suppress T4 levels in cats.
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Hypothyroidism is predominantly caused by secondary factors in dogs.
Hypothyroidism is predominantly caused by secondary factors in dogs.
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Match the following clinical signs of hyperthyroidism in cats with their descriptions:
Match the following clinical signs of hyperthyroidism in cats with their descriptions:
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What hormone is produced by parafollicular cells in the thyroid gland?
What hormone is produced by parafollicular cells in the thyroid gland?
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In dogs, 90% of thyroid tumors are _____ in nature.
In dogs, 90% of thyroid tumors are _____ in nature.
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Match the following diseases with their effects on insulin:
Match the following diseases with their effects on insulin:
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The major storage form of thyroid hormone is _____, while the main biologically active form is _____.
The major storage form of thyroid hormone is _____, while the main biologically active form is _____.
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Which hormone is generally increased in hyperthyroid cats?
Which hormone is generally increased in hyperthyroid cats?
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In newborn lambs, goitre can be a consequence of iodine excess in the diet.
In newborn lambs, goitre can be a consequence of iodine excess in the diet.
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Match the following thyroid-related terms with their definitions:
Match the following thyroid-related terms with their definitions:
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What is the most common cause of diabetes mellitus in dogs?
What is the most common cause of diabetes mellitus in dogs?
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Free T4 is always low in cats with hyperthyroidism.
Free T4 is always low in cats with hyperthyroidism.
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What is a significant risk of goitre in neonatal lambs?
What is a significant risk of goitre in neonatal lambs?
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Which breed of dog is NOT commonly associated with hypothyroidism?
Which breed of dog is NOT commonly associated with hypothyroidism?
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The increase in TSH in goitre is stimulated by a fall in __________ levels.
The increase in TSH in goitre is stimulated by a fall in __________ levels.
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Calcitonin increases ionised serum calcium concentration in the blood.
Calcitonin increases ionised serum calcium concentration in the blood.
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What type of animal is primarily affected by thyroid adenocarcinomas?
What type of animal is primarily affected by thyroid adenocarcinomas?
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What is the average age at which clinical signs of hypothyroidism commonly develop in dogs?
What is the average age at which clinical signs of hypothyroidism commonly develop in dogs?
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The endocrine pancreas is comprised of _______ cells that secrete insulin.
The endocrine pancreas is comprised of _______ cells that secrete insulin.
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Match the following terms to their correct description concerning thyroid gland conditions:
Match the following terms to their correct description concerning thyroid gland conditions:
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Match the following pancreatic cell types with their secretions:
Match the following pancreatic cell types with their secretions:
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What is a common clinical sign of hyperthyroidism in cats?
What is a common clinical sign of hyperthyroidism in cats?
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The rise in _____ levels due to low thyroid hormones stimulates the release of THR from the hypothalamus.
The rise in _____ levels due to low thyroid hormones stimulates the release of THR from the hypothalamus.
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What hormonal imbalance is often associated with obesity in cats?
What hormonal imbalance is often associated with obesity in cats?
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Human recombinant TSH is a cost-effective alternative for veterinary use.
Human recombinant TSH is a cost-effective alternative for veterinary use.
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What is a common clinical sign of hypothyroidism in dogs?
What is a common clinical sign of hypothyroidism in dogs?
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What laboratory test is typically used to assess thyroid function in cats?
What laboratory test is typically used to assess thyroid function in cats?
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Insulinoma is a benign tumor that does not require urgent treatment.
Insulinoma is a benign tumor that does not require urgent treatment.
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High levels of TRH provide positive feedback to the thyroid gland.
High levels of TRH provide positive feedback to the thyroid gland.
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What condition occurs due to the inadequate production of insulin to meet metabolic demands?
What condition occurs due to the inadequate production of insulin to meet metabolic demands?
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In the absence of kidney disease, ________ levels are typically low due to reduced muscle mass.
In the absence of kidney disease, ________ levels are typically low due to reduced muscle mass.
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What occurs in lymphocytic thyroiditis?
What occurs in lymphocytic thyroiditis?
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Secondary hypothyroidism in dogs is primarily caused by a _____ that destroys TSH-producing cells in the pituitary.
Secondary hypothyroidism in dogs is primarily caused by a _____ that destroys TSH-producing cells in the pituitary.
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Somatostatin inhibits the release of _____ and _____ as well as digestive enzymes.
Somatostatin inhibits the release of _____ and _____ as well as digestive enzymes.
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Which of the following is NOT a function of thyroid hormones?
Which of the following is NOT a function of thyroid hormones?
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What is the most common type of anemia observed in endocrine disease?
What is the most common type of anemia observed in endocrine disease?
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Hypercholesterolaemia is typically seen in about 50% of hypothyroid cases.
Hypercholesterolaemia is typically seen in about 50% of hypothyroid cases.
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What would you expect Total T4 (TT4) levels to do in dogs with hypothyroidism?
What would you expect Total T4 (TT4) levels to do in dogs with hypothyroidism?
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The presence of _______ indicates thyroid pathology but does not provide information about thyroid function.
The presence of _______ indicates thyroid pathology but does not provide information about thyroid function.
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Match the thyroid test with its significance:
Match the thyroid test with its significance:
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Which of the following conditions can lead to suppressed Total T4 (TT4) levels?
Which of the following conditions can lead to suppressed Total T4 (TT4) levels?
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The presence of an elevated TSH level is a confirmatory indicator of hypothyroidism.
The presence of an elevated TSH level is a confirmatory indicator of hypothyroidism.
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What is euthyroid sick syndrome?
What is euthyroid sick syndrome?
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Mild _____ enzyme elevations may be seen in about 30% of dogs with hypothyroidism.
Mild _____ enzyme elevations may be seen in about 30% of dogs with hypothyroidism.
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Match the serum concentration levels with their typical association in hypothyroid dogs:
Match the serum concentration levels with their typical association in hypothyroid dogs:
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Which medication is known to potentially suppress T4 levels?
Which medication is known to potentially suppress T4 levels?
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Free T4 levels are significantly affected by various external factors.
Free T4 levels are significantly affected by various external factors.
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What is the primary purpose of the oral glucose test in horses?
What is the primary purpose of the oral glucose test in horses?
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What is the role of Reverse T3 in thyroid hormone metabolism?
What is the role of Reverse T3 in thyroid hormone metabolism?
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Excessive fasting prior to measuring basal insulin is recommended.
Excessive fasting prior to measuring basal insulin is recommended.
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What clinical sign is most commonly associated with insulinoma due to severe hypoglycemia?
What clinical sign is most commonly associated with insulinoma due to severe hypoglycemia?
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Low Total T4 may be due to hypothyroidism, another disease, or ______.
Low Total T4 may be due to hypothyroidism, another disease, or ______.
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The insulin response remains _____ in horses with EMS compared to normal horses after the Insulin Response Test.
The insulin response remains _____ in horses with EMS compared to normal horses after the Insulin Response Test.
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Match the following tests with their primary focus in assessing insulin dysregulation:
Match the following tests with their primary focus in assessing insulin dysregulation:
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What is a key characteristic of insulin concentrations in horses with EMS during the oral sugar test?
What is a key characteristic of insulin concentrations in horses with EMS during the oral sugar test?
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Insulinomas are exclusively found in dogs.
Insulinomas are exclusively found in dogs.
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What management practice should be avoided before insulin and glucose testing?
What management practice should be avoided before insulin and glucose testing?
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The combined glucose insulin test is useful to indicate _____ dysregulation in horses.
The combined glucose insulin test is useful to indicate _____ dysregulation in horses.
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Which hormone is primarily secreted in excess by insulinomas?
Which hormone is primarily secreted in excess by insulinomas?
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What is produced when two acetyl-CoA molecules combine?
What is produced when two acetyl-CoA molecules combine?
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Acetoacetic acid is the only ketone body produced during ketosis.
Acetoacetic acid is the only ketone body produced during ketosis.
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What condition is characterized by an accumulation of ketones and metabolic acidosis?
What condition is characterized by an accumulation of ketones and metabolic acidosis?
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Increased levels of _____ hormones contribute to ketone formation.
Increased levels of _____ hormones contribute to ketone formation.
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Match the following clinical signs with their descriptions:
Match the following clinical signs with their descriptions:
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What does hyperglycaemia indicate in relation to Diabetic Ketoacidosis?
What does hyperglycaemia indicate in relation to Diabetic Ketoacidosis?
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Urinary dipsticks can detect acetoacetic acid and acetone.
Urinary dipsticks can detect acetoacetic acid and acetone.
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What is the primary feature of Equine Metabolic Syndrome (EMS)?
What is the primary feature of Equine Metabolic Syndrome (EMS)?
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Adipose tissue acts as an _____ organ, releasing hormones that affect various bodily functions.
Adipose tissue acts as an _____ organ, releasing hormones that affect various bodily functions.
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Which of the following best indicates the presence of insulin resistance in horses?
Which of the following best indicates the presence of insulin resistance in horses?
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All obese horses will develop Equine Metabolic Syndrome.
All obese horses will develop Equine Metabolic Syndrome.
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What may characterize the fat deposition in a horse with EMS?
What may characterize the fat deposition in a horse with EMS?
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What is the main consequence of amylin accumulation in the islets?
What is the main consequence of amylin accumulation in the islets?
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Chronic hyperglycaemia can lead to 'glucose toxicity' in β cells.
Chronic hyperglycaemia can lead to 'glucose toxicity' in β cells.
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Acute stress and pain generally result in _____ insulin concentration.
Acute stress and pain generally result in _____ insulin concentration.
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Match the following conditions with their clinical signs:
Match the following conditions with their clinical signs:
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What is a common clinical sign of diabetes mellitus in dogs?
What is a common clinical sign of diabetes mellitus in dogs?
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In diabetic cats, damage to nerve myelin sheaths can cause _________ hindlimb stance.
In diabetic cats, damage to nerve myelin sheaths can cause _________ hindlimb stance.
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Match the following clinical signs with their causes:
Match the following clinical signs with their causes:
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Which component is used to reflect average glucose concentration over three to four weeks in diabetic patients?
Which component is used to reflect average glucose concentration over three to four weeks in diabetic patients?
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Diabetic ketoacidosis can only be mild and is rarely life-threatening.
Diabetic ketoacidosis can only be mild and is rarely life-threatening.
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What is a possible cause of urinary tract infections in diabetic patients?
What is a possible cause of urinary tract infections in diabetic patients?
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Elevated liver enzymes in diabetic patients are often due to ________ infiltration.
Elevated liver enzymes in diabetic patients are often due to ________ infiltration.
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What age group of dogs is most commonly affected by diabetes mellitus?
What age group of dogs is most commonly affected by diabetes mellitus?
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Fructosamine concentrations should ideally be higher in females than in males.
Fructosamine concentrations should ideally be higher in females than in males.
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How does insulin affect the hypothalamic satiety center?
How does insulin affect the hypothalamic satiety center?
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In diabetes mellitus, the presence of glucosuria leads to ________ diuresis.
In diabetes mellitus, the presence of glucosuria leads to ________ diuresis.
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Match the following breeds or conditions with their affected populations:
Match the following breeds or conditions with their affected populations:
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What is the common method to differentiate between transient hyperglycaemia and true hyperglycaemia?
What is the common method to differentiate between transient hyperglycaemia and true hyperglycaemia?
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Study Notes
Endocrine System Overview
- Endocrine glands consist of specialized cells creating and releasing hormones into the bloodstream.
- Hormones act on distal target organs through specific receptor binding, regulating body processes.
- Hormone production adjusts in response to changes in extracellular fluid to maintain homeostasis.
- Key endocrine glands: hypothalamus, pituitary, thyroid, parathyroid, adrenal glands, pancreas, pineal gland, ovaries, and testes.
- Additional endocrine functions found in the liver, adipose tissue, gastrointestinal tract, and heart.
- Endocrine diseases often arise from hormonal deficiencies or excesses.
Hormone Secretion Variability
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Reduced Hormone Secretion:
- Destruction of glandular tissue or secretory cells leads to decreased hormone production.
- In hypoadrenocorticism, adrenal destruction results in insufficient cortisone and aldosterone.
- Trophic hormone reduction, such as TSH and ACTH due to pituitary tumors, affects target gland functions.
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Increased Hormone Secretion:
- Hyperplasia or tumors increase hormone production; e.g., hyperthyroidism in elderly cats.
- Excess trophic hormone leads to hyperplasia in target glands; e.g., pituitary-dependent hyperadrenocorticism.
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Iatrogenic Effects:
- Prolonged external hormone therapy (e.g., prednisone) can mimic disease states.
Pituitary Gland Structure and Functions
- The pea-sized pituitary gland consists of anterior (adenohypophysis) and posterior (neurohypophysis) parts.
- Anterior pituitary hormones include ACTH, TSH, growth hormone, and reproductive hormones.
- The posterior pituitary releases oxytocin and ADH synthesized in the hypothalamus.
- Hormone release is regulated through negative feedback loops, ensuring hormone levels remain stable.
Pituitary Disorders
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Pituitary Pars Intermedia Dysfunction (PPID):
- Common in older horses; excess POMC-derived peptide production leads to symptoms like hirsutism and weight gain.
- Diagnosis often requires ACTH levels and can be complicated by seasonal increases.
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ACTH-Secreting Tumors:
- Benign adenomas that cause adrenal hyperplasia and Cushing’s syndrome in dogs.
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Acromegaly:
- Caused by growth hormone overproduction via pituitary adenoma in cats, leading to distinctive physical features and insulin resistance.
Adrenal Gland Overview
- The adrenal gland, located atop the kidneys, is divided into the medulla (catecholamines) and cortex (steroid hormones).
- Cortex zones include:
- Zona Glomerulosa: Produces aldosterone; regulates sodium and potassium.
- Zona Fasciculata: Produces cortisol; involved in metabolism and immune response regulation.
- Zona Reticularis: Produces minor amounts of sex steroids.
Adrenal Disorders
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Adrenal Hyperplasia and Neoplasia:
- Chronic ACTH stimulation, often from pituitary adenomas, leads to adrenal cortex enlargement.
- Adrenal tumors can be functional (excess cortisol) or non-functional (cause pressure effects).
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Cushing’s Syndrome (Hyperadrenocorticism):
- Caused by adrenal tumors, accounting for 15-20% of cases in dogs.
Diagnostic Approaches
- Diagnosing endocrine disorders can involve various hormonal assays and imaging techniques.
- ACTH tests, TRH stimulation, and dexamethasone suppression tests are pivotal in assessing pituitary and adrenal function.
- Accurate interpretation of results is critical due to physiological variations and potential cross-interferences.
Clinical Signs of Endocrine Disorders
- Common signs include changes in coat appearance, thirst, urination, weight fluctuations, and altered appetite.
- Recognizing overlapping clinical signs amongst different conditions (e.g., PPID vs. equine metabolic syndrome) is essential for accurate diagnosis.
- Clinical pathology aids diagnosis but should be complemented with hormonal testing and imaging for comprehensive evaluation.### Hyperadrenocorticism Overview
- Secondary hyperadrenocorticism, primarily caused by an ACTH-producing pituitary adenoma, accounts for 80-85% of Cushing’s cases in dogs.
- Corticosteroid administration can induce iatrogenic hyperadrenocorticism.
Clinical Signs of Cushing’s Syndrome
- Common symptoms include polyuria (PU), polydipsia (PD), polyphagia, weakness leading to a pot-bellied appearance, and hepatomegaly due to glycogen accumulation.
- Alopecia affects over 90% of dogs with Cushing’s; calcinosis cutis is present in approximately 40% of cases.
- Affected dogs exhibit increased susceptibility to skin, urinary tract, and respiratory infections.
Clinical Pathology Findings
Haematology
- Leukocytosis with stress leukogram: mature neutrophilia, lymphopenia, eosinopenia, monocytosis.
- Neutrophilia and monocytosis arise from reduced margination and emigration; lymphopenia from steroid-induced lymphocytolysis.
Biochemistry
- Significant increase in alkaline phosphatase (ALP) seen in ~95% of patients; levels can be 5-40 times normal.
- Mild elevation of ALT due to hepatomegaly; increased cholesterol and triglycerides from glucocorticoid effects on fat metabolism.
- Elevated glucose levels result from increased gluconeogenesis and insulin antagonism.
Urinalysis
- Urine specific gravity (SG) varies but is typically less than 1.007; urinary tract infections are common.
- Collect urine before hospitalization to minimize stress-related changes.
Screening Tests for Hyperadrenocorticism
- Testing should be postponed if an animal is seriously ill due to confounding results from concurrent diseases.
- Candidates for testing include dogs with suggestive history, physical exam findings, pituitary tumors, and those with difficult-to-manage diabetes.
Diagnostic Tests
Urinary Cortisol:Creatinine Ratio (UCCR)
- Simple screening test; sensitivity improves with home-collected urine samples.
- A positive result requires further confirmation with LDDST or ACTH stimulation test.
Low Dose Dexamethasone Suppression Test (LDDST)
- First-choice screening test, unless iatrogenic Cushing’s suspected; involves blood sampling before and after dexamethasone administration.
- Normal dogs suppress cortisol; dogs with Cushing’s do not exhibit expected suppression.
ACTH Stimulation Test (ACTH stim)
- Gold standard for diagnosing iatrogenic hyperadrenocorticism; measures adrenal cortex response to synthetic ACTH.
- Sensitivity ranges from 57-95%, lower in dogs with adrenal tumors.
Discriminatory Tests
- Important to differentiate between pituitary-dependent hyperadrenocorticism (PDH) and adrenal-dependent hyperadrenocorticism (ADH).
- High Dose Dexamethasone Suppression Test (HDDST), ACTH concentration, and ultrasonography are utilized for differentiation.
High Dose Dexamethasone Suppression Test (HDDST)
- High doses suppress ACTH secretion from pituitary microadenomas; non-functioning adrenal tumors do not show suppression.
ACTH Measurement
- Accurate differentiating test, but currently unavailable in some regions; requires precise sample handling and storage.
Ultrasound
- Useful for distinguishing PDH and ADH; in PDH, adrenal glands are symmetrical; ADH presents asymmetrical glands with possible tumor invasion.
Hyperadrenocorticism in Cats
- Mostly pituitary-dependent (approximately 80%); common clinical signs include PU/PD, abdominal enlargement, polyphagia, and skin atrophy.
- Clinical pathology shows unremarkable haematology or stress leukogram; hyperglycaemia is prevalent.
Adrenal Neoplasia in Ferrets
- Commonly caused by adrenocortical adenomas leading to progressive alopecia; excess estrogen may cause bone marrow suppression.
Phaeochromocytoma
- Tumors of the adrenal medulla, often non-functional; when functional, they can result in severe cardiovascular symptoms.
- Malignant forms may invade local structures including the caudal vena cava.
Adrenocortical Atrophy and Hypoadrenocorticism
- Caused by destructive lesions in the pituitary or idiopathic atrophy in dogs; results in glucocorticoid and mineralocorticoid deficiencies.
- Addison’s disease presents with numerous clinical signs including weakness and dehydration.
Hypoadrenocorticism Clinical Pathology
Haematology
- May show mild non-regenerative anemia and an atypical leukogram with lymphocytosis.
Biochemistry
- Prerenal azotaemia due to low sodium retention; electrolyte imbalances commonly include hyperkalaemia and hyponatraemia.
- A Na:K ratio of less than 25:1 strongly suggests hypoadrenocorticism.
Screening Tests
- Basal cortisol is typically decreased; the ACTH stimulation test confirms diagnosis by demonstrating lack of cortisol response.
Atypical Addison’s Disease
- Some dogs present with nonspecific signs without classic electrolyte abnormalities; may eventually develop classical Addison’s with time.
Other Adrenal Lesions
- Nodular cortical hyperplasia is a common incidental finding in older dogs, often non-pathological and not requiring treatment.
Lipids, Cholesterol, and Endocrine Diseases
- Plasma lipids include triglycerides and cholesterol; important for energy metabolism and cell structure.
- Hyperlipidaemia refers to increased circulating lipids; lipaemia indicates visible turbidity in blood samples.### Lipaemia and Lab Tests
- Lipaemia affects spectrophotometric lab tests, leading to falsely elevated glucose, albumin, phosphorus, and bilirubin levels, while total protein and albumin results may appear decreased.
Causes of Hyperlipidaemia
- Postprandial hyperlipidaemia is common in cats and dogs, resulting in increased triglycerides 1-2 hours post-meal, peaking at 6-8 hours; fasting for 12 hours before a blood sample can prevent this.
- Endocrine diseases such as hypothyroidism, diabetes mellitus, hyperadrenocorticism, and acromegaly cause hyperlipidaemia due to reduced LDL receptor activity, decreased biliary cholesterol excretion, and insulin resistance.
- Cholestasis results in reduced hepatic cholesterol uptake and impaired bile cholesterol excretion.
- Pancreatitis increases cholesterol synthesis and causes cholestasis, affecting lipid metabolism.
- Nephrotic syndrome leads to proteinuria and hypoalbuminaemia, causing hypercholesterolaemia through urinary loss of enzymes and impaired hepatic function.
- Primary hyperlipidaemia occasionally seen in certain dog breeds (e.g., miniature schnauzers) linked to genetic defects in lipid metabolism.
- Anorexia, particularly in horses and cats, can cause hyperlipidaemia and hepatic lipidosis due to negative energy balance and increased free fatty acid mobilization.
Thyroid Glands Anatomy and Function
- The thyroid gland typically has two lobes on either side of the trachea in most animals; dogs typically have the right gland cranial to the left.
- Histology reveals cells lining large colloid-filled follicles; hormone synthesis occurs mainly in these follicles.
- Thyroglobulin synthesizes T3 (triiodothyronine) and T4 (thyroxine); T4 production is about 20 times higher than T3.
Thyroid Hormone Regulation
- The hypothalamic-pituitary-thyroid axis regulates thyroid hormone production; low levels trigger TRH release, stimulating TSH from the pituitary, thereby stimulating thyroid hormone synthesis.
- T4 is mainly bound to proteins like albumin, with about 1% of T4 being 'free' T4; T3 is primarily bound to albumin.
Physiological Effects of Thyroid Hormones
- Thyroid hormones increase basal metabolic rate, protein synthesis, glucose metabolism, lipid breakdown, cholesterol conversion to bile acids, and cardiac function.
Parafollicular Cells
- Parafollicular or C cells produce calcitonin which, in response to high blood calcium levels, promotes calcium excretion and inhibits osteoclast activity.
Hypothyroidism in Dogs
- Most common endocrinopathy in dogs, often over-diagnosed; true prevalence uncertain.
- Primary hypothyroidism (95% cases) mainly results from lymphocytic thyroiditis or idiopathic thyroid atrophy; secondary hypothyroidism occurs due to pituitary tumors.
- Commonly observed in purebred dogs (e.g., Golden Retrievers, Boxers).
Primary Hypothyroidism Pathophysiology
- Lymphocytic thyroiditis involves lymphocyte infiltration and cell destruction; clinical signs appear after 75% gland destruction.
- Idiopathic thyroid atrophy results in thyroid follicle degeneration; often appears unrelated to lymphocytic thyroiditis.
Clinical Signs of Hypothyroidism
- Symptoms include lethargy, weight gain, cold intolerance, skin issues, hair loss, and variable combinations of these signs; can mimic aging.
Clinical Pathology in Hypothyroidism
- Normocytic normochromic anaemia present in ~40% of cases.
- Common biochemistry findings include hypercholesterolaemia and hypertriglyceridaemia due to decreased hepatic lipoprotein metabolism.
Testing and Diagnosis
- Total T4 is a key parameter for thyroid function assessment; it is sensitive but not specific for hypothyroidism.
- Low T4 may occur in non-thyroidal illnesses (euthyroid sick syndrome) and various medications must be considered.
Confirmatory Testing
- TSH levels increase in primary hypothyroidism due to reduced negative feedback; concurrent non-thyroidal illness can suppress TSH levels.
- Free T4 is the active hormone and is less affected by external factors; it is typically low in hypothyroid dogs but may be impacted by some medications.
Treatment Monitoring
- Serum TT4 is monitored at specific intervals after starting therapy or adjusting doses to assess treatment efficacy.
Goitre and Thyroid Hyperplasia
- Goitre refers to thyroid enlargement from nutritional deficiency or goitrogenic substances, particularly common in animals with iodine deficiency.
- Multifocal nodular hyperplasia occurs mostly in older cats, dogs, and horses, with cats being prone to hyperthyroidism.
Hyperthyroidism in Cats
- Most common endocrinopathy, affecting mainly elderly cats; often undetermined if due to hyperplasia or adenoma formation.
- Clinical signs include weight loss, increased appetite, hyperactivity, and potential complications like systemic hypertension and cardiac issues.
Importance of Laboratory Testing
- Laboratory tests are critical for accurate diagnosis, as many clinical signs are non-specific and may overlap with other diseases.
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Description
This quiz provides an overview of endocrine glands, focusing on their structure, function, and the role of hormones in the body. Learn how these specialized cells release hormones into the bloodstream and their effects on target organs. Test your understanding of the mechanisms that maintain hormonal balance in the body.