Endocrinology 653

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(1/3) A 6 year old FS poodle presents with PU/PD, pot belly, polyphagia, and muscle wasting. Her CBC shows a stress leukogram and erythrocytosis. The serum chemistry shows increased ALP and ALT, hypertriglyceridemia, and increased bile acids. Her systolic blood pressure reads as 172 mmHg. What is the most likely diagnosis?

Cushing's disease

(2/3) Continuing the case from question 1, you decide to run a low dose dexamethasone suppression test (LDDST) based on your suspicion of Cushing's disease. Your results are as follows: 8 hr sample > lab cut off, 4 hr sample > lab cut off. What do these results indicate?

These results could indicate either pituitary dependent hyperadrenocorticism or an adrenal tumor. Further testing is needed

(3/3) Based on the results from question 2, you decide to run a high dose dexamethasone test (HHDST) to determine if this dog has PDH or AT. Your 8 hr sample is > the lab cut off, your 4 hr and 8 hr sample is < 50% baseline. What is your diagnosis based on these results?

Pituitary dependent hyperadrenocorticism

What is the only test that can be used to definitively diagnose pituitary dependent hyperadrenocorticism (PDH)?

High dose dexamethasone suppression test

(1/3) A 7 year old MC standard poodle presents to your clinic for lethargy, vomiting, diarrhea, anorexia, and PU/PD. He is bradycardic with poor pulse quality, dehydrated, and hypothermic. The CBC does not show a stress leukogram, but lymphocytosis is appreciated. His serum chemistry shows hyperkalemia, azotemia,and hyponatremia. Based on these findings, what is the most likely diagnosis?

Addison's disease

(2/3) Based on your answer from question 5, what test would you like to run next?

ACTH stimulation test

(3/3) You decide to run an ACTH stimulation test based on your suspicion of Addison's disease. You give synthetic ACTH and recheck in 1 hour. Your results show no response to the synthetic ACTH given. Does this confirm your suspected diagnosis of Addison's disease?

Yes

What test is best for diagnosing aldosterone deficiency?

Paired serum aldosterone and plasma renin

What is the drug of choice for long term management of Addison's disease?

DOCP

(1/3) A 3 year old FS lab presents for lethargy, weight gain, and a poor coat. The CBC shows normocytic normochromic non-regenerative anemia. Her chemistry shows hypercholesterolemia and hypertriglyceridemia on a fasted sample. Based on the signalment and lab findings, what is the most likely diagnosis?

Hypothyroidism

(2/3) You suspect hypothryoidism for your lab patients. Which of these diagnostic tests would be the best at confirming this diagnosis?

Free T4

(3/3) What is the recommended treatment option for hypothyroidism?

Levothyroxine

Weight loss with polyphagia is characteristic of which of these endocrine diseases?

Hyperthyroidism

Which of these statements regarding hyperthyroidism is false?

Patients commonly present with chronic weight loss with polyphagia and are comatose, bradycardic, and have PU/PD

Which of the following organ systems is not involved in maintaining calcium homeostasis?

Liver

Which of the following is not a cause of hypercalcemia?

CNS disease

Which of these findings would be consistent with hypoparathyroidism?

Low PTH, low vitamin D, low calcium, high phosphorus

True or False: Calcium gluconate can be given IV.

False

Ferrets with insulinoma who present with signs such as slowing down, hind limb weakness, staring off into space, lethargy, and exercise intolerance have ____ neuroglycopenia.

Chronic

Which of the following statements about insulinoma in ferrets is false?

Often malignant with a high rate of metastasis

What is the treatment of choice for adrenocortical disease in ferrets?

Suprelorin F (deslorelin) implant

Which of these statements is true regarding adrenal surgery?

The adrenal glands are identified by the phrenicoabdominal vein coursing over the gland

Which of these statements about thyroidectomy is false?

Often requires concurrent removal of the regional lymph nodes, which is typically the submandibular lymph nodes

All of the following are clinical signs of post-op parathyroidectomy that should be monitored EXCEPT: Soft tissue likes to ask this on clinics FYI

Hypothyroidism

How does insulinoma differ in dogs in comparison to ferrets?

Essentially all insulinomas in dogs are malignant, whereas essentially all are benign in ferrets

Up to ____% of the pancreas can be removed w/o impacting endocrine and exocrine function, unless pre-existing condition is present.

80%

Which of the following is not a primary target of insulin?

Kidney

Which of the following is a difference in Diabetes Mellitus in cats vs dogs?

Male cats are more commonly affected than females, whereas in dogs, females are more commonly affected

Which of these species would be LEAST likely to develop metabolic bone disease (hyperparathyroidism)?

Corn snake

What is the most likely diagnosis for a 2 year old bearded dragon who presents comatose with a BG of 450 mg/dl?

Gastric Neuroendocrine Carcinoma

True or False: Glipizide can be used for the management of Diabetes Mellitus in both dogs and cats.

False

Which of the following insulins would be best to give in a DKA crisis?

Regular

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