Endocrine Disorders Flashcards
What condition is characterized by the excess secretion of PTH from one or more parathyroid glands?
Primary hyperparathyroidism
What is the most common cause of primary hyperparathyroidism?
Parathyroid adenoma
What gene mutation is implicated in some cases of parathyroid adenomas?
CASR gene
In cases of primary hyperparathyroidism, PTH will remain elevated despite increasing ____ levels
Ca2+
How does hyperparathyroidism affect bone?
- increased osteoclastic activity
- decreased osteoblastic activity
How does hyperparathyroidism affect the kidneys?
- increased reabsorption of Ca
- increased excretion of phosphate
- increased calcitriol production
What are some of the generalized signs and symptoms of Hypocalcemia?
- hyperactive reflexes
- spontaneous m. contractions
- convulsions
- laryngeal spasm w/ airway obstruction
- severe m. cramps
- mild tingling in hands and feet
- depression, paranoia, psychosis
What physiological events occur in Dissecting osteitis?
- 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
What physiological events occur in Osteitis fibrosa?
- Accelerated bone remodeling
- Trabeculae is resorbed
- Bone marrow replaced by fibrous tissue, macrophages, areas of hemorrhage from microfractures, and reactive bone formation
What physiological events occur in Osteitis fibrosa cystica?
- Brown tumors (geographic lytic lesion) develop which contain osteoclastic giant cells
- Visible bone changes on radiographic images
What are some of the radiographic characteristics of Primary Hyperparathyroidism?
- 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)
What is the most common location of subperiosteal resorption?
radial aspect, middle phalanx, of 2nd & 3rd digits
What are some of the clinical manifestations of a patient with primary hyperparathyroidism?
- 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)
What is the best treatment options for Primary Hyperparathyroidism?
Surgical removal of the parathyroid gland adenoma
What condition is characterized by an increase in PTH secretion due to chronic renal failure?
Secondary Hyperparathyroidism
What condition is characterized by a parathyroid hyperplasia and hypercalcemia from long-standing secondary hyperparathyroidism?
Tertiary Hyperparathyroidism
What refers to the bone changes seen in patients with secondary/tertiary hyperparathyroidism due to end-stage kidney disease?
Renal Osteodystrophy
What radiographic finding is associated with renal osteodystrophy in the spine?
Rugger-jersey spine
How does hyperparathyroidism affect the intestines?
increased calbindin –> decreases vit D
Hyperphosphatemia can lead to what conditions in soft tissues?
Metastatic calcifications
What condition is commonly seen in dialysis patients that result in the bones to become more brittle and prone to fracture?
Adynamic variant of renal osteodystrophy (ARO)
What are some of the treatment options for Secondary Hyperparaythyroidism?
- Treatment for renal failure
- Vitamin D supplementation
- Drug therapy to control phosphate levels
What condition is characterized by the decreased PTH secretion?
Hypoparathyroidism
What is the most common cause of Hypoparathyroidism?
Idiopathic parathyroid atrophy
What conditions is characterized by a mutation of the GNAS1 gene that affects the PTH receptor of end organs leading to Hypocalcemia?
Psuedohypoparathyroidism
What condition is a type of psuedohypoparathyroidism that results in a short stature, mental retardation, and short metacarpals and metatarsals?
Albright Hereditary Osteodystrophy
What are the expected serum calcium levels in Primary Hyperparathyroid patients?
Elevated
What are the expected PTH levels in Primary Hyperparathyroid patients
Elevated
What are the expected serum phosphate levels in Primary Hyperparathyroid patients
Decreased
What are the expected PTH levels in Secondary Hyperparathyroid patients?
Elevated
What are the expected serum calcium levels in Secondary Hyperparathyroid patients?
Decreased
What are the expected serum phosphate levels in Secondary Hyperparathyroid patients?
Elevated
What are the expected PTH levels in Hypoparathyroid patients?
Decreased
What are the expected serum calcium levels in Hypoparathyroid patients?
Decreased
What are the expected serum phosphate levels in Hypoparathyroid patients?
Normal
What are the expected serum calcium levels in Pseudohypoparathyroid patients?
Decreased
What are the expected PTH levels in Psuedohypoparathyroid patients?
Elevated
What are the expected serum phosphate levels in Pseudohypoparathyroid patients?
Normal
What are the expected serum calcium levels in Hypervitaminosis D patients?
Elevated
What are the expected PTH levels in Hypervitaminosis D patients?
Decreased
What are the expected serum phosphate levels in Hypervitaminosis D patients?
Decreased
What are the expected serum calcium levels in Osteomalacia patients?
Decreased
What are the expected PTH levels in Osteomalacia patients?
Elevated
What are the expected serum phosphate levels in Osteomalacia patients?
Decreased
What is the most common cause of gigantism?
Somatotrope adenoma
What condition is characterized by the increased secretion of Growth Hormone leading to enlargement of the extremities?
Acromegaly
What condition is characterized by the hypersecretion of growth hormone during the early years of life?
Gigantism
What endocrine condition leads to a symmetrical overgrowth in all tissues that can result in increased height?
Gigantism
What is your biggest concern in patients with Gigantism?
Cardiovascular issues
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
What is the best treatment options for patients with Gigantism/Acromegaly?
Pituitary adenoma removal
TRUE or FALSE:
Somatotrope adenomas can lead to secondary reproductive issues due to pituitary hypofunctioning
True
