Difference between revisions of "Equine Internal Medicine Q&A 04"
Ggaitskell (talk | contribs) (Created page with "{{Template:Manson Mair}} centre|500px<br> <br /> '''A 23-year-old mixed breed horse is examined because of failure to shed its wi...") |
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*Pituitary adenoma (hirsutism) | *Pituitary adenoma (hirsutism) | ||
*Chronic obstructive pulmonary disease (COPD) | *Chronic obstructive pulmonary disease (COPD) | ||
| − | |l1= | + | |l1=Pituitary Neoplasia |
|q2=What further diagnostic tests should be performed to help confirm your diagnosis? | |q2=What further diagnostic tests should be performed to help confirm your diagnosis? | ||
|a2=The age of the horse, clinical signs and hyperglycaemia in combination are virtually diagnostic of pituitary adenoma. <br><br> | |a2=The age of the horse, clinical signs and hyperglycaemia in combination are virtually diagnostic of pituitary adenoma. <br><br> | ||
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There are many other tests that could be performed but none appear to be as sensitive and specific as the TRF response or ACTH measurement or as easy as the plasma insulin (a single sample is all that is required). <br><br> | There are many other tests that could be performed but none appear to be as sensitive and specific as the TRF response or ACTH measurement or as easy as the plasma insulin (a single sample is all that is required). <br><br> | ||
A tracheal wash or bronchoalveolar lavage would be indicated to help confirm the diagnosis of COPD. | A tracheal wash or bronchoalveolar lavage would be indicated to help confirm the diagnosis of COPD. | ||
| − | |l2= | + | |l2=Pituitary Gland - Anatomy & Physiology |
|q3=How might the elevation in liver enzymes be related to one of the physically apparent disorders? | |q3=How might the elevation in liver enzymes be related to one of the physically apparent disorders? | ||
|a3= | |a3= | ||
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*A liver biopsy might also be indicated since the cause of the elevated liver enzyme activity is not proven.<br><br> | *A liver biopsy might also be indicated since the cause of the elevated liver enzyme activity is not proven.<br><br> | ||
In this case the microscopic diagnosis was hepatic lipidosis. This is likely to be related to the pituitary adenoma and the resulting increase in lipolysis. | In this case the microscopic diagnosis was hepatic lipidosis. This is likely to be related to the pituitary adenoma and the resulting increase in lipolysis. | ||
| − | |l3= | + | |l3=Hepatic Lipidosis |
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</FlashCard> | </FlashCard> | ||
Revision as of 17:40, 5 June 2011
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This question was provided by Manson Publishing as part of the OVAL Project. See more Equine Internal Medicine questions |
A 23-year-old mixed breed horse is examined because of failure to shed its winter coat, chronic coughing and, more recently, partial anorexia and loss of weight. A serum chemistry had the following abnormalities: hyperglycaemia (9.2mmol/l; 166mg/dl) and increased liver enzyme activity (AST, 560u/l; GGT, 167u/l). Clinical examination reveals widespread wheezes during thoracic auscultation. The temperature and heart rate are normal but the respiratory rate is elevated (20bpm) and there appears to be an increase in expiratory effort.
| Question | Answer | Article | |
| What diseases are most probable from the clinical examination of this patient? |
|
Link to Article | |
| What further diagnostic tests should be performed to help confirm your diagnosis? | The age of the horse, clinical signs and hyperglycaemia in combination are virtually diagnostic of pituitary adenoma. Further confirmatory tests might include:
There are many other tests that could be performed but none appear to be as sensitive and specific as the TRF response or ACTH measurement or as easy as the plasma insulin (a single sample is all that is required). |
Link to Article | |
| How might the elevation in liver enzymes be related to one of the physically apparent disorders? |
In this case the microscopic diagnosis was hepatic lipidosis. This is likely to be related to the pituitary adenoma and the resulting increase in lipolysis. |
Link to Article | |
