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Describe the hormones of the HPG axis?
Hypothalmus releases LHRH which stimulates the pituitary to release LH and FSH, which stimulates the ovaries to produce progesterone and estrogen
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Describe the hormones of the HPT axis?
Hypothalamus produces TRH which stimulates the pituitary to produce TSH, which stimulates the thyroid gland to produce T3 and T4
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What type of lab tests are used in endocrine system?
plasma hormone concentrations, urinary excretion, dynamic testing
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What is used to diagnose hyperadrenocorticism?
Low dose dexamethasone suppression test
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What is the sensitivity and specificity of the LDDST?
sensitivity 95%, not very specific
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When should you measure cortisol in LDDST?
0 hours, 4 hours, 8 hours
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What hour should you look at first with LDDST?
8 hours, if high indicates hyperadrenocorticism
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What is the % that have the disease that test +, gives you the false negative rate?
sensitivity
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What is the % that do not have the disease that test -, gives you the false positive rate?
specificity
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What do positive predictive value and negative predictive value depend on?
prevalence
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What does angiotensin II stimulate?
sympathetic activity, tubular NaCl reabsorption and K excretion, H2O retention, aldosterone secretion, arteriolar vasoconstriction increase in blood pressure, pituitary gland (posterior lobe) to secrete ADH, which goes into collecting duct: H2O absorption
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PTH will cause will cause an increase in what and a decrease in what?
increase in serum calcium and decrease in serum PO4
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Calcitonin will cause a decrease in what?
both serum Ca and serum PO4
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Vitamin D3 causes an increase in what?
both serum Ca and serum PO4
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What are some functions of insulin?
glucose uptake, glucose storage, FA synthesis, inhibits fat breakdown, fat sparing, AA uptake, K+ uptake
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What are anti-insulin hormones?
epinephrine, cortisol, glucagon, growth hormone, +/- progesterone, GHRH, ACTH
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What may be the initial sign of diabetes mellitus in dogs?
cataracts
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What may be the initial sign of diabetes mellitus in dogs?
peripheral neuropathy (plantigrade stance)
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What are clinical signs of diabetes mellitus in non-ketotic stable?
weight loss in the face of an increased intake, polyphagia, PU/PD, cataracts
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What are the clinical signs of diabetes mellitus in ketoacidotic/non-ketotic hyperosmolar?
weight loss, PU/PD, dehydration, labored breathing, lethargy/collapse/stupor, NKH
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How do you diagnose diabetes mellitus?
BG >200 mg/dl in dogs , BG >300 mg/dL in cats
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What bloodwork test is the test of choice to diagnose diabetes mellitus in dogs?
free t4 and TSH
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What would the serum chemistry look like in diabetic dogs?
dehydration, azotemic, elevated TP, elevated cholesterol and triglycerides, low sodium
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What ketoacids are detected by urine dipstick in diabetes mellitus?
acetone, acetoacetate, B hydroxybutyrate (most prevalent)
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What are diagnostic tests for diabetes mellitus?
urinalysis, urine culture, ketoacids, serum fructosamine, glycosylated hemoglobin, full health screening
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What is the most common endocrine disorder of cats?
hyperthyroidism
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What percent of the of bilateral hyperthyroidism?
70%
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What percent of hyperthyroidism that is from thyroid carcinoma?
1-2%
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What is included in the history and PE of hyperthyroidism?
weight loss, PU/PD, polyphagia, vomiting/diarrhea, hyperactivity, weakness, dyspnea/panting, palpable thyroid, systolic murmur, tachycardia, gallop rhythm, aggressive
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What disease does hyperthyroidism contribute to because hypertension, increased GFR, and sclerosis?
CKD
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What should be elevated in the CBC/Chem of hyperthyroidism?
ALT, ALP, LDH, AST, glucose, azotemia, phosphorus, bilirubin
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What are ECG findings in hyperthyroidism?
tachycardia, increased R wave, ventricular arrhythmias, conduction abnormalities, thyrotoxic cardiomyopathy
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What test is diagnostic for hyperthyroid in cats?
high total T4
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What is a screening test for hypothyroid?
free T4 and TSH
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What are mineralcorticoids involved in adrenocortical function?
aldosterone, salt and water, electrolytes, ECF
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What are glucocorticoids involved in adrenocortical function?
cortisol
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What are androgens involved in adrenocortical function?
DHEA
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What is a peptide hormone from hypothalamus, release is stimulated by stress?
CRH
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What is the most common endocrinopathy of dogs?
hyperadrenocorticism
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What will the CBC/chem/UA look like in hyperadrenocorticism?
stress leukogram, elevated (glucose, ALT, cholesterol, ALP), dilute urine, proteinuria
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What are screening tests involved in hyperadrenocorticism?
chemistry, urine cortisol/creatine ratio
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What are diagnostic tests involved in hyperadrenocorticism?
ACTH stimulation test, low-dose dexamethazone suppression test
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How much of the cardiac output does the liver see?
1/3
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How much of the livers blood supply comes from the portal vein?
80%
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How much of the livers blood supply comes from the hepatic artery?
20%
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What does the portal triad of the liver consist of?
portal vein, hepatic artery, bile duct
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What type of blood flow does the liver have?
- afferent blood supply: hepatic artery, portal vein
- Efferent blood supply: hepatic vein
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What are the hepatic lobules seperated by?
CT capsule
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What are the components of the hepatic sinusoids?
hepatocytes, endothelial cells, and kupffer cells
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What are macrophages that patrol the sinusoids, ability to "see" portal blood first?
kupffer cells
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Where is bile secreted from?
H-cytes
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Does bile flow in the same or opposite direction than blood?
opposite direction
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What are the responsibilities of the liver?
excretion, detoxification, secretion, metabolism, production, storage
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The liver has detoxification properties, how does it modify exogenous/endogenous compounds?
ammonium fixation and phylloerythrin
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What is present in herbivores and is a by-product of chlorophyll metabolism?
phylloerythrin
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