Clin Med I

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HLW
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152480
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Clin Med I
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2012-05-06 08:57:59
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Clin Med
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Clin Med I
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  1. 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
  2. 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
  3. What type of lab tests are used in endocrine system?
    plasma hormone concentrations, urinary excretion, dynamic testing
  4. What is used to diagnose hyperadrenocorticism?
    Low dose dexamethasone suppression test
  5. What is the sensitivity and specificity of the LDDST?
    sensitivity 95%, not very specific
  6. When should you measure cortisol in LDDST?
    0 hours, 4 hours, 8 hours
  7. What hour should you look at first with LDDST?
    8 hours, if high indicates hyperadrenocorticism
  8. What is the % that have the disease that test +, gives you the false negative rate?
    sensitivity
  9. What is the % that do not have the disease that test -, gives you the false positive rate?
    specificity
  10. What do positive predictive value and negative predictive value depend on?
    prevalence
  11. 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
  12. PTH will cause will cause an increase in what and a decrease in what?
    increase in serum calcium and decrease in serum PO4
  13. Calcitonin will cause a decrease in what?
    both serum Ca and serum PO4
  14. Vitamin D3 causes an increase in what?
    both serum Ca and serum PO4
  15. What are some functions of insulin?
    glucose uptake, glucose storage, FA synthesis, inhibits fat breakdown, fat sparing, AA uptake, K+ uptake
  16. What are anti-insulin hormones?
    epinephrine, cortisol, glucagon, growth hormone, +/- progesterone, GHRH, ACTH
  17. What may be the initial sign of diabetes mellitus in dogs?
    cataracts
  18. What may be the initial sign of diabetes mellitus in dogs?
    peripheral neuropathy (plantigrade stance)
  19. What are clinical signs of diabetes mellitus in non-ketotic stable?
    weight loss in the face of an increased intake, polyphagia, PU/PD, cataracts
  20. What are the clinical signs of diabetes mellitus in ketoacidotic/non-ketotic hyperosmolar?
    weight loss, PU/PD, dehydration, labored breathing, lethargy/collapse/stupor, NKH
  21. How do you diagnose diabetes mellitus?
    BG >200 mg/dl in dogs , BG >300 mg/dL in cats
  22. What bloodwork test is the test of choice to diagnose diabetes mellitus in dogs?
    free t4 and TSH
  23. What would the serum chemistry look like in diabetic dogs?
    dehydration, azotemic, elevated TP, elevated cholesterol and triglycerides, low sodium
  24. What ketoacids are detected by urine dipstick in diabetes mellitus?
    acetone, acetoacetate, B hydroxybutyrate (most prevalent)
  25. What are diagnostic tests for diabetes mellitus?
    urinalysis, urine culture, ketoacids, serum fructosamine, glycosylated hemoglobin, full health screening
  26. What is the most common endocrine disorder of cats?
    hyperthyroidism
  27. What percent of the of bilateral hyperthyroidism?
    70%
  28. What percent of hyperthyroidism that is from thyroid carcinoma?
    1-2%
  29. 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
  30. What disease does hyperthyroidism contribute to because hypertension, increased GFR, and sclerosis?
    CKD
  31. What should be elevated in the CBC/Chem of hyperthyroidism?
    ALT, ALP, LDH, AST, glucose, azotemia, phosphorus, bilirubin
  32. What are ECG findings in hyperthyroidism?
    tachycardia, increased R wave, ventricular arrhythmias, conduction abnormalities, thyrotoxic cardiomyopathy
  33. What test is diagnostic for hyperthyroid in cats?
    high total T4
  34. What is a screening test for hypothyroid?
    free T4 and TSH
  35. What are mineralcorticoids involved in adrenocortical function?
    aldosterone, salt and water, electrolytes, ECF
  36. What are glucocorticoids involved in adrenocortical function?
    cortisol
  37. What are androgens involved in adrenocortical function?
    DHEA
  38. What is a peptide hormone from hypothalamus, release is stimulated by stress?
    CRH
  39. What is the most common endocrinopathy of dogs?
    hyperadrenocorticism
  40. What will the CBC/chem/UA look like in hyperadrenocorticism?
    stress leukogram, elevated (glucose, ALT, cholesterol, ALP), dilute urine, proteinuria
  41. What are screening tests involved in hyperadrenocorticism?
    chemistry, urine cortisol/creatine ratio
  42. What are diagnostic tests involved in hyperadrenocorticism?
    ACTH stimulation test, low-dose dexamethazone suppression test
  43. How much of the cardiac output does the liver see?
    1/3
  44. How much of the livers blood supply comes from the portal vein?
    80%
  45. How much of the livers blood supply comes from the hepatic artery?
    20%
  46. What does the portal triad of the liver consist of?
    portal vein, hepatic artery, bile duct
  47. What type of blood flow does the liver have?
    • afferent blood supply: hepatic artery, portal vein
    • Efferent blood supply: hepatic vein
  48. What are the hepatic lobules seperated by?
    CT capsule
  49. What are the components of the hepatic sinusoids?
    hepatocytes, endothelial cells, and kupffer cells
  50. What are macrophages that patrol the sinusoids, ability to "see" portal blood first?
    kupffer cells
  51. Where is bile secreted from?
    H-cytes
  52. Does bile flow in the same or opposite direction than blood?
    opposite direction
  53. What are the responsibilities of the liver?
    excretion, detoxification, secretion, metabolism, production, storage
  54. The liver has detoxification properties, how does it modify exogenous/endogenous compounds?
    ammonium fixation and phylloerythrin
  55. What is present in herbivores and is a by-product of chlorophyll metabolism?
    phylloerythrin

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