NYCC MSP > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

(52 cards)

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1
Q

What condition is characterized by the excess secretion of PTH from one or more parathyroid glands?

A

Primary hyperparathyroidism

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2
Q

What is the most common cause of primary hyperparathyroidism?

A

Parathyroid adenoma

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3
Q

What gene mutation is implicated in some cases of parathyroid adenomas?

A

CASR gene

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4
Q

In cases of primary hyperparathyroidism, PTH will remain elevated despite increasing ____ levels

A

Ca2+

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5
Q

How does hyperparathyroidism affect bone?

A
  • increased osteoclastic activity
  • decreased osteoblastic activity
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6
Q

How does hyperparathyroidism affect the kidneys?

A
  • increased reabsorption of Ca
  • increased excretion of phosphate
  • increased calcitriol production
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7
Q

What are some of the generalized signs and symptoms of Hypocalcemia?

A
  • hyperactive reflexes
  • spontaneous m. contractions
  • convulsions
  • laryngeal spasm w/ airway obstruction
  • severe m. cramps
  • mild tingling in hands and feet
  • depression, paranoia, psychosis
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8
Q

What physiological events occur in Dissecting osteitis?

A
  • Osteoclasts are stimulated by the increased PTH levels
  • Cutting cones into subperiosteal and endosteal surfaces of cortical bone
  • Collagen is laid down adjacent to trabeculae
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9
Q

What physiological events occur in Osteitis fibrosa?

A
  • Accelerated bone remodeling
  • Trabeculae is resorbed
  • Bone marrow replaced by fibrous tissue, macrophages, areas of hemorrhage from microfractures, and reactive bone formation
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10
Q

What physiological events occur in Osteitis fibrosa cystica?

A
  • Brown tumors (geographic lytic lesion) develop which contain osteoclastic giant cells
  • Visible bone changes on radiographic images
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11
Q

What are some of the radiographic characteristics of Primary Hyperparathyroidism?

A
  • Fractures
  • Osteolysis
  • “Lace-like” appearance of bone
  • Loss of cortical line definition
  • Appearance of brown tumors
  • Soft tissue calcifications (metastatic)
  • subperiosteal resorption
  • subchondral resorption (later sign)
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12
Q

What is the most common location of subperiosteal resorption?

A

radial aspect, middle phalanx, of 2nd & 3rd digits

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13
Q

What are some of the clinical manifestations of a patient with primary hyperparathyroidism?

A
  • Hypercalcemia (persistence leads to impaired renal function, eventual failure) -> Kidney stones
  • Peptic ulcers (GI problems)
  • MSK pain (wave-like back pain)
  • Fracture
    (Stones, groans, moans, bones)
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14
Q

What is the best treatment options for Primary Hyperparathyroidism?

A

Surgical removal of the parathyroid gland adenoma

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15
Q

What condition is characterized by an increase in PTH secretion due to chronic renal failure?

A

Secondary Hyperparathyroidism

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16
Q

What condition is characterized by a parathyroid hyperplasia and hypercalcemia from long-standing secondary hyperparathyroidism?

A

Tertiary Hyperparathyroidism

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17
Q

What refers to the bone changes seen in patients with secondary/tertiary hyperparathyroidism due to end-stage kidney disease?

A

Renal Osteodystrophy

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18
Q

What radiographic finding is associated with renal osteodystrophy in the spine?

A

Rugger-jersey spine

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19
Q

How does hyperparathyroidism affect the intestines?

A

increased calbindin –> decreases vit D

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20
Q

Hyperphosphatemia can lead to what conditions in soft tissues?

A

Metastatic calcifications

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21
Q

What condition is commonly seen in dialysis patients that result in the bones to become more brittle and prone to fracture?

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A

Adynamic variant of renal osteodystrophy (ARO)

22
Q

What are some of the treatment options for Secondary Hyperparaythyroidism?

Study These Flashcards
A
  • Treatment for renal failure
  • Vitamin D supplementation
  • Drug therapy to control phosphate levels
23
Q

What condition is characterized by the decreased PTH secretion?

Study These Flashcards
A

Hypoparathyroidism

24
Q

What is the most common cause of Hypoparathyroidism?

Study These Flashcards
A

Idiopathic parathyroid atrophy

25
What conditions is characterized by a mutation of the GNAS1 gene that affects the PTH receptor of end organs leading to Hypocalcemia?
Psuedohypoparathyroidism
26
What condition is a type of psuedohypoparathyroidism that results in a short stature, mental retardation, and short metacarpals and metatarsals?
Albright Hereditary Osteodystrophy
27
What are the expected serum calcium levels in Primary Hyperparathyroid patients?
Elevated
28
What are the expected PTH levels in Primary Hyperparathyroid patients
Elevated
29
What are the expected serum phosphate levels in Primary Hyperparathyroid patients
Decreased
30
What are the expected PTH levels in Secondary Hyperparathyroid patients?
Elevated
31
What are the expected serum calcium levels in Secondary Hyperparathyroid patients?
Decreased
32
What are the expected serum phosphate levels in Secondary Hyperparathyroid patients?
Elevated
33
What are the expected PTH levels in Hypoparathyroid patients?
Decreased
34
What are the expected serum calcium levels in Hypoparathyroid patients?
Decreased
35
What are the expected serum phosphate levels in Hypoparathyroid patients?
Normal
36
What are the expected serum calcium levels in Pseudohypoparathyroid patients?
Decreased
37
What are the expected PTH levels in Psuedohypoparathyroid patients?
Elevated
38
What are the expected serum phosphate levels in Pseudohypoparathyroid patients?
Normal
39
What are the expected serum calcium levels in Hypervitaminosis D patients?
Elevated
40
What are the expected PTH levels in Hypervitaminosis D patients?
Decreased
41
What are the expected serum phosphate levels in Hypervitaminosis D patients?
Decreased
42
What are the expected serum calcium levels in Osteomalacia patients?
Decreased
43
What are the expected PTH levels in Osteomalacia patients?
Elevated
44
What are the expected serum phosphate levels in Osteomalacia patients?
Decreased
45
What is the most common cause of gigantism?
Somatotrope adenoma
46
What condition is characterized by the increased secretion of Growth Hormone leading to enlargement of the extremities?
Acromegaly
47
What condition is characterized by the hypersecretion of growth hormone during the early years of life?
Gigantism
48
What endocrine condition leads to a symmetrical overgrowth in all tissues that can result in increased height?
Gigantism
49
What is your biggest concern in patients with Gigantism?
Cardiovascular issues
50
What are some of the clinical manifestations of patients with Gigantism/Acromegaly?
- Increased facial robusticity/coarsening of features - Increased size of hands and feet - Diabetes mellitus type 2 sequels - Hypofunctioning pituitary gland - Organ enlargement
51
What is the best treatment options for patients with Gigantism/Acromegaly?
Pituitary adenoma removal
52
TRUE or FALSE: Somatotrope adenomas can lead to secondary reproductive issues due to pituitary hypofunctioning
True
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