Hormonal Diseases Flashcards
Hyperparathyroidism is the result of overactivity of which gland?
Parathyroid
Is PTH a strong osteoblastic or osteoclastic hormone?
Osteoclastic
What is the most common cause of hypercalcemia?
Primary hyperparathyroidism caused by parathyroid adenoma (90%)
Hypercalcemia due to high PTH levels leads to a deficiency of what mineral?
Phosphate
What is the cause of secondary HPT?
Complication of chronic renal disease
Tertiary HPT is seen in what population?
Dialysis patients
What is tertiary HPT?
When the parathyroid gland acts independently from serum calcium levels
HPT is more common in what gender and what age range?
Females aged 30-50
What are the symptoms of HPT?
Bone pain, fractures, lethargy, polyuria
What are the symptoms of hypercalcemia seen with HPT?
Muscle weakness and hypertonia
What elevated lab levels are seen with PTH?
Alkaline phosphatase and PTH
What GI complications can be seen with HPT?
Rengal stones, pancreatitis
What is the diagnostic and hallmark feature of HPT seen on X-ray?
Subperiosteal resorption
What is the term for the cystic accumulations of fibrous tissue commonly seen with HPT?
Brown tumor
What is the most common location for subperiosteal resorption that is seen with HPT?
RADIAL margins of the middle and proximal phalanges of the 2nd and 3rd digits
What unique dental feature is seen with HPT?
Loss of the lamina dura of the teeth
What kind of resorption is seen at the distal phalanges of the fingers with HPT?
Ungal tuft resorption
The SI involvement with HPT can resemble what other condition but what also sets it apart?
AS (if HPT, renal stones or kidney issues are likely present)
What radiographic features are more sensitive to hyperparathyroidism?
Rugger jersey spine, subperiosteal resorption at SI joints, salt-and-pepper skull
What is unique about the radiographic features of HPT following treatment?
Radiographic features disappear
What causes the rugged jersey spine appearance in HPT?
Calcium deposits in vertebral endplates leading to sclerosis
If bilateral symmetric SI joint widening and resorption is present, what 3 conditions could be assumed?
AS, enteropathic arthropathy, HPT (rule out with history)
What is another name for a Brown tumor?
Osteoclastoma
What causes the “brown” appearance of an osteoclastoma?
Hemosiderin from the focal hemorrhage
What is the most common location for a brown tumor?
Can centrally happen anywhere (geographic)
What hormones are released from the anterior pituitary? Posterior?
Anterior = GH, ACTH, TSH, FSH/LH, Prolactin Posterior = ADH, oxytocin
What type of tumor accounts for 10% of all neoplasms of the cranium?
Pituitary
Autopsies have revealed that what percentage of the population actually have small pituitary adenomas?
25%!
What are the general symptoms of a pituitary adenoma?
HEADACHES, visual disturbances, generalized discomfort in extremities
What are the normal dimensions of the sella turcica?
12 mm depth, 16 mm sagittal plane
How would we know if an enlarged sella turcica is only a normal variant in that patient?
No present symptoms
Acromegaly and gigantism predispose an individual to what condition that larges impacts their skeletal system?
DJD (also a reduced lifespan)
Acromegaly and gigantism primarily affect which body parts?
Hands and feet (acral parts)
What causes acromegaly?
Over-secretion of growth hormone from a pituitary adenoma
What does acromegaly mean?
“Large extremities”
A pragmatic jaw is indicative of what condition?
Acromegaly
What is the key difference between acromegaly and gigantism?
Acromegaly is not accompanied by an increase in height
What are the radiographic features associated with acromegaly?
“Spade-like” distal tufts (phalanges), hooking osteophytes, increased tissue thickness
The hooked osteophytes seen in acromegaly can be compared to what other condition?
Hemochromatosis (look at history)
What radiographic feature of acromegaly can be seen on the skull X-ray?
Prominent frontal sinus and forehead
What unique radiographic sign of acromegaly can be seen in the feet?
Increased heal pad thickness (normal is 8-12mm)
What is the term for an enlarged tongue, commonly seen in acromegaly?
Macroglossia
Which involves an over-secretin of growth hormone PRIOR to skeletal maturity: acromegaly or gigantism?
Gigantism (open physis)
What is another name for Cushing’s disease?
Hypercortisolism
What causes Cushing’s?
Increased production of cortisol or excessive use of cortisol or other steroid hormones
What is the most common cause of hypercortisolism?
EXOgenous corticosteroid administration in patients requiring immunosuppression
What is the most common cause of Cushing’s?
ENDOgenous over-secretion by ACTH, adrenal cortex, or tumor
What are common visual signs seen in patients with Cushing’s?
“Moon face”, “buffalo hump”, accelerated hair growth, purple straie on abdomen, weight gain
What serious bone complication can be seen in those with Cushing’s due to prolonged corticosteroid use?
AVN
