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NYCC MSP > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

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?

A

Adynamic variant of renal osteodystrophy (ARO)

22
Q

What are some of the treatment options for Secondary Hyperparaythyroidism?

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?

A

Hypoparathyroidism

24
Q

What is the most common cause of Hypoparathyroidism?

A

Idiopathic parathyroid atrophy

25
Q

What conditions is characterized by a mutation of the GNAS1 gene that affects the PTH receptor of end organs leading to Hypocalcemia?

A

Psuedohypoparathyroidism

26
Q

What condition is a type of psuedohypoparathyroidism that results in a short stature, mental retardation, and short metacarpals and metatarsals?

A

Albright Hereditary Osteodystrophy

27
Q

What are the expected serum calcium levels in Primary Hyperparathyroid patients?

A

Elevated

28
Q

What are the expected PTH levels in Primary Hyperparathyroid patients

A

Elevated

29
Q

What are the expected serum phosphate levels in Primary Hyperparathyroid patients

A

Decreased

30
Q

What are the expected PTH levels in Secondary Hyperparathyroid patients?

A

Elevated

31
Q

What are the expected serum calcium levels in Secondary Hyperparathyroid patients?

A

Decreased

32
Q

What are the expected serum phosphate levels in Secondary Hyperparathyroid patients?

A

Elevated

33
Q

What are the expected PTH levels in Hypoparathyroid patients?

A

Decreased

34
Q

What are the expected serum calcium levels in Hypoparathyroid patients?

A

Decreased

35
Q

What are the expected serum phosphate levels in Hypoparathyroid patients?

A

Normal

36
Q

What are the expected serum calcium levels in Pseudohypoparathyroid patients?

A

Decreased

37
Q

What are the expected PTH levels in Psuedohypoparathyroid patients?

A

Elevated

38
Q

What are the expected serum phosphate levels in Pseudohypoparathyroid patients?

A

Normal

39
Q

What are the expected serum calcium levels in Hypervitaminosis D patients?

A

Elevated

40
Q

What are the expected PTH levels in Hypervitaminosis D patients?

A

Decreased

41
Q

What are the expected serum phosphate levels in Hypervitaminosis D patients?

A

Decreased

42
Q

What are the expected serum calcium levels in Osteomalacia patients?

A

Decreased

43
Q

What are the expected PTH levels in Osteomalacia patients?

A

Elevated

44
Q

What are the expected serum phosphate levels in Osteomalacia patients?

A

Decreased

45
Q

What is the most common cause of gigantism?

A

Somatotrope adenoma

46
Q

What condition is characterized by the increased secretion of Growth Hormone leading to enlargement of the extremities?

A

Acromegaly

47
Q

What condition is characterized by the hypersecretion of growth hormone during the early years of life?

A

Gigantism

48
Q

What endocrine condition leads to a symmetrical overgrowth in all tissues that can result in increased height?

A

Gigantism

49
Q

What is your biggest concern in patients with Gigantism?

A

Cardiovascular issues

50
Q

What are some of the clinical manifestations of patients with Gigantism/Acromegaly?

A
  • Increased facial robusticity/coarsening of features
  • Increased size of hands and feet
  • Diabetes mellitus type 2 sequels
  • Hypofunctioning pituitary gland
  • Organ enlargement
51
Q

What is the best treatment options for patients with Gigantism/Acromegaly?

A

Pituitary adenoma removal

52
Q

TRUE or FALSE:
Somatotrope adenomas can lead to secondary reproductive issues due to pituitary hypofunctioning

A

True

NYCC MSP (28 decks)

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