VM 583 - Clinical Pathology Exam 2 WITH COMPLETE
QUESTIONS AND CORRECT DETAILED
ANSWERRS\VERIFIED 100% ALREADY GRADED A+
\ACTUAL EXAM VM 583 BEST DOCUMENT FOR EXAM 2
PREP
If Ammonia and Bile acids are both severely increased, what would
be the pathophysiologic abnormality?
enterohepatic circulation or portosystemic shunt
Hypoalbuminemia:
a) Decreases bound calcium
b) Decreases complexed calcium
c) Switches some bound calcium to free calcium and thus
increases free calcium
d) Decreases free calcium
Decreases bound calcium
, What is the net effect of PTH on calcium (Ca) and phosphorus (P)?
a) ↑Ca, ↑P
b) ↑Ca, ↓P
c) ↓Ca, ↓P
d) ↓Ca, ↑P
↑Ca, ↓P
A dog presents with true hypercalcemia. Additional investigation
shows increased PTH. PTHrp is undetectable. What is your
interpretation?
a) A & B are both true as there is a feedback loop
b) Increased PTH causes hypercalcemia
c) We can't tell what is causing what
d) Hypercalcemia causes increased PTH
Increased PTH causes hypercalcemia
,Which is true about calcium endocrine regulation?
a) Calcium endocrine regulation is based on free calcium
b) Calcitonin is a hypercalcemic hormone
c) Calcitriol (activated vitamin D) is a hypocalcemic hormone
d) PTH is a hypocalcemic hormone
Calcium endocrine regulation is based on free calcium
An old cat with advanced chronic kidney disease presents with
calcium within reference interval (RI), close from the lower end of
the RI, and has marked hyperphosphatemia. What is this cat most
likely to have?
a) Primary hyperparathyroidism
b) Secondary hyperparathyroidism
c) Primary hypoparathyroidism
d) No calcium disorder
Secondary hyperparathyroidism
Total calcium: 7.9 mg/dL (10.1 - 13.2 mg/dL) Free calcium: 0.4 mmol/L
(0.91 -
1.32 mmol/L) Phosphorus: 8.6 mg/dL (4.1 - 7.1 mg/dL).
Considering the Ca/P derangements, what hormone is likely
abnormal? And would this hormone be low or high?
PTH is likely low
, What are 3 differentials for true hypercalcemia in a cat; which
measurements would help you rule them in or out?
1. Humoral hypercalcemia of malignancy would have increased PTHrp
2. Primary hyperparathyroidism would have increased PTH
3. Idiopathic hypercalcemia would have a low PTH
Total calcium: 13.3 mg/dL (9.0 - 11.5 mg/dL) Free calcium: 1.72 mmol/L
(1.12 -
1.40 mmol/L) Phosphorus: 1.9 mg/dL (2.5 - 6.0 mg/dL) PTH: WRI
(repeatably). Between calcium and PTH, which is the cause and which
is the consequence of the problem? Why?
With overt hypercalcemia, PTH should decrease; here, PTH WRI =
inadequate response! PTH = the problem (no sensitivity to high
calcium: loss of regulation); consequence = high calcium
Total calcium: 13.3 mg/dL (9.0 - 11.5 mg/dL) Free calcium: 1.72 mmol/L
(1.12 -
1.40 mmol/L) Phosphorus: 1.9 mg/dL (2.5 - 6.0 mg/dL) PTH: WRI
(repeatably). How do you explain the hypophosphatemia?
Excess of PTH activity (unregulated PTH)
QUESTIONS AND CORRECT DETAILED
ANSWERRS\VERIFIED 100% ALREADY GRADED A+
\ACTUAL EXAM VM 583 BEST DOCUMENT FOR EXAM 2
PREP
If Ammonia and Bile acids are both severely increased, what would
be the pathophysiologic abnormality?
enterohepatic circulation or portosystemic shunt
Hypoalbuminemia:
a) Decreases bound calcium
b) Decreases complexed calcium
c) Switches some bound calcium to free calcium and thus
increases free calcium
d) Decreases free calcium
Decreases bound calcium
, What is the net effect of PTH on calcium (Ca) and phosphorus (P)?
a) ↑Ca, ↑P
b) ↑Ca, ↓P
c) ↓Ca, ↓P
d) ↓Ca, ↑P
↑Ca, ↓P
A dog presents with true hypercalcemia. Additional investigation
shows increased PTH. PTHrp is undetectable. What is your
interpretation?
a) A & B are both true as there is a feedback loop
b) Increased PTH causes hypercalcemia
c) We can't tell what is causing what
d) Hypercalcemia causes increased PTH
Increased PTH causes hypercalcemia
,Which is true about calcium endocrine regulation?
a) Calcium endocrine regulation is based on free calcium
b) Calcitonin is a hypercalcemic hormone
c) Calcitriol (activated vitamin D) is a hypocalcemic hormone
d) PTH is a hypocalcemic hormone
Calcium endocrine regulation is based on free calcium
An old cat with advanced chronic kidney disease presents with
calcium within reference interval (RI), close from the lower end of
the RI, and has marked hyperphosphatemia. What is this cat most
likely to have?
a) Primary hyperparathyroidism
b) Secondary hyperparathyroidism
c) Primary hypoparathyroidism
d) No calcium disorder
Secondary hyperparathyroidism
Total calcium: 7.9 mg/dL (10.1 - 13.2 mg/dL) Free calcium: 0.4 mmol/L
(0.91 -
1.32 mmol/L) Phosphorus: 8.6 mg/dL (4.1 - 7.1 mg/dL).
Considering the Ca/P derangements, what hormone is likely
abnormal? And would this hormone be low or high?
PTH is likely low
, What are 3 differentials for true hypercalcemia in a cat; which
measurements would help you rule them in or out?
1. Humoral hypercalcemia of malignancy would have increased PTHrp
2. Primary hyperparathyroidism would have increased PTH
3. Idiopathic hypercalcemia would have a low PTH
Total calcium: 13.3 mg/dL (9.0 - 11.5 mg/dL) Free calcium: 1.72 mmol/L
(1.12 -
1.40 mmol/L) Phosphorus: 1.9 mg/dL (2.5 - 6.0 mg/dL) PTH: WRI
(repeatably). Between calcium and PTH, which is the cause and which
is the consequence of the problem? Why?
With overt hypercalcemia, PTH should decrease; here, PTH WRI =
inadequate response! PTH = the problem (no sensitivity to high
calcium: loss of regulation); consequence = high calcium
Total calcium: 13.3 mg/dL (9.0 - 11.5 mg/dL) Free calcium: 1.72 mmol/L
(1.12 -
1.40 mmol/L) Phosphorus: 1.9 mg/dL (2.5 - 6.0 mg/dL) PTH: WRI
(repeatably). How do you explain the hypophosphatemia?
Excess of PTH activity (unregulated PTH)
