Endocrine diseases

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  • Created by: Cal1234
  • Created on: 16-04-19 13:52
what is diabetes mellitus
failure of body to regulate blood glucose levels due to production or response to insulin, results in persistence hypergylcaemia
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what is type 1 diabetes mellitus and which species is it linked to
insulin dependent diabetes mellitus, dogs
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what occurs with type 1 diabetes mellitus
reduced or absent insulin production, islet cell destruction, immune mediated or secondary response to pancreatitis
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what is type 2 diabetes mellitus and which species is it linked to
non-insulin dependent diabetes mellitus, cats
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what occurs with type 2 diabetes mellitus
insulin resistance, bod doesn't respond to insulin, obesity, medications, other endocrine conditions, insulin production may be normal/increased leading to islet cell exhaustion and cell death
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clinical sings of diabetes mellitus
PUPD, polyphagia, weight loss, lethargy, cataracts (dogs), neuropathy (cats), hepatomegaly, ketoacidosis
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what will blood/urinalysis show
persistant hyperglycaemia, elevated fructosamine, persistant glucosuria, ketonuria
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how is diabetes mellitus managed
insulin supplementation every 12 hrs, monitor using BGC, fructosamine, timing, quantity and type of diet must be constant, low carb, mod fat and increased insoluble fibre, weight loss plan in obese, manage UTI, dental disease and neuter entire female
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what can happen with cats
some cats can enter remission and no longer require exogenous insulin
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what is diabetes insipidous
reduction in secretion or action of antidiuretic hormone, so unable to concentrate urine
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what are the two types of diabetes insipidus
centeral, nephrogenic
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what is central diabetes insipidus
failure of posterior pituitary gland to release ADH
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what is nephrogenic diabetes insidious
ADH is released normally but nephrons fail to respond, may be secondary to renal disease, hypercalcaemia or toxoemia e.g. pyometra
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clinical sings of diabetes insipidus
PUPD, dehydration,
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Diagnosis of diabetes insipidus
USG <1.008 - hyposthennuria, water eleprivation test, response to synthetic ADH
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what is another name for hyperadrenocorticism
cushings disease
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what does hyperadrenocorticisms result from
chronic exposure to effects of glucocorticoids
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what are the thee types of hyperadrenocorticism
pituitary dependent, adernal dependent, iatrogenic
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what percentage of cases are pituitary dependent
80
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what causes pituitary dependent HAC
benign tumour of pituitary gland producing ACTH
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what causes adrenal dependent HAC
tumour of adrenal gland producing corticosteroids
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what causes iatrogenic HAC
prolonged or high does of corticosteroid medication
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what does haematology show on diagnosis
neutrophillia, esinophillia and leucopenia
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what does biochemistry show on diagnosis
increased ALP, increased chloesterol and bile acids, possible hyperglycemia
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what does urinalysis show on diagnosis
low USG, urine corticosol:creatinine ratio
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what 3 stimulations tests can be performed
ACTH, low does dexamethasone stimulations test (LDDST)
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what is another name for hyopadrenocorticism
Addisons disease
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what is hypoadrenocorticism
failure to secrete adequate glucocorticoids and mineralocorticoids
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what are the two types of hypoadrencorticism
primary, secondary
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what is primary hypoadrenocorticisms
immune mediated
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what is secondary hyopadrenocorticism
iatrogenic, sudden withdrawal of exogenous steroids
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what are the clinical signs of hypoadrenocorticism
vague and intermittent, lethargy, weight loss, vomiting, abdominal pain, may present as addisonian crisis
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what are the signs of an addisonian crisis
hypovalemia, hypotension, bradycardia, collapse
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diagnosis of hypoadrenocorticism
hypovolaemic shock, increased PCV, Azotaemia, low NA and CL with high K, ACTH stimulations - no cortisol produced
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what is the treatment of addisons disease
management of hypovolemic shock, correct electrolyte balance, supplement glucocorticoids - IV, supplement mineralocorticoids - DOCP (zycortal) injections, life long supplementation
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what is hypothyridism and what species is it most common in
decrease in circulating thyroxine (T4), dogs
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what does hypothyroidism cause
slows metabolic rate
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what are the three types of hypothyroidism
primary, secondary, iatrogenic
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what are the two types of primary hypothyroidism
acquired (90%), congenital - rare
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what does acquired primary hypothyroidism involve
destruction of thyroid tissue via lymphocytic thyroiditis
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what is secondary hypothyroidism
involves pituitary gland and reduced TSH - rare
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what is iatrogenic hypothyroidism
following removal of thyroid glands (cats)
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What breeds are predisposed to hypothyroidism
labradors, golden retrievers, dobermans, cocker spaniels, boxers
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what are the clinical signs of hypothyroidism
lethargy and exercise intolerance, weight gain despite normal appetite, symmetrical flank alopecia, hypothermia - thickened pigmented skin, bradycardia - neurological defects
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what is the diagnosis of hypothyroidism
clinical signs supported by bloods: non regenerative anaemia, hypercholesterolemia, low T4 with high TSH
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what is the treatment and care of hypothyroidism
keep warm, supplement with synthetic thyroxin, regular monitoring of T4 blood levels
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What is hyperthyroidism and what species is it more common in
excessive production of T4 and T3, increases metabolic rate, cat
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what is hyperthyroidism usually caused by
tumour of thyroid gland, most often hyperplasia or thyroid adenoma (benign)
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what are the clinical signs of hyperthyroidism
polyphagia, hyperactivity, weight loss, tachycardia, hypertension can lead to blindness, v/d, palpable goiter (enlarged thyroid gland), poor skin and coat condition
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what is the diagnosis of hyperthyroidism
T4 levels, may mask signs of CKD - check urea and creatinine
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what are the four treatments of hyperthyroidism
medical managemen, surgical thyroidectomy, radioactive iodine, iodine restricted diet
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what is medical management
inhibit enzymes for thyroid hormone production
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surgical thyroidectomy
curative providing all tissue removed, possible complication of hypocalcemia and seizures due to removal of parathyroid glands
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radioactive iodine
curative, taken into thyroid cells and destroys them
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iodine restricted diet
to limit synthesis of T4 and T3
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what is hypoparathyroidism
insufficient PTH production
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what are the two types of hypoparathyroidism
primary, iatrogenic
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what is primary hypoparathyroidism
idiopathic/immune mediated
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what is iatrogenic hypoparathyroidism
thyroidectomy
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what are the clinical signs of hypoparathyroidism
resistant hypocalcemia - tremors, ataxia, weakness, seizures
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what is hyperparathyroidism
excessive production of parathormone PTH
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what are the two types of hyperparathyroidism
primary, secondary
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what is primary hyperparathyroidism
tumour of parathyroid, hypercalcaemia and hyperphosphataemia, renal failure and urolithiasis, increased resorption from bone - reduced mineralization, pathological fractures
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what is secondary hyperparathyroidism
caused by disease elsewhere, renal - renal failure, decreased phosphate secretion leads to PTH release seen frequently in dogs. nutritional - diets contain low Ca: P ration e.g. liver causes excess PTH release
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clinical signs of hypoparathyroidism
hypercalcaemia - PUPD, low USG, anorexia, weakness, excersize intolerance, tremors. osteodystrophy
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treatment of hyperparathyroidism
primary - removal of glands, secondary to renal - diet and phosphate binders, secondary to nutrition - correct diet and Vitamin D supplement
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Card 2

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what is type 1 diabetes mellitus and which species is it linked to

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insulin dependent diabetes mellitus, dogs

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what occurs with type 1 diabetes mellitus

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Card 4

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what is type 2 diabetes mellitus and which species is it linked to

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Card 5

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what occurs with type 2 diabetes mellitus

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