Hormonal Diseases Flashcards

1
Q

Hyperparathyroidism is the result of overactivity of which gland?

A

Parathyroid

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2
Q

Is PTH a strong osteoblastic or osteoclastic hormone?

A

Osteoclastic

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3
Q

What is the most common cause of hypercalcemia?

A

Primary hyperparathyroidism caused by parathyroid adenoma (90%)

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4
Q

Hypercalcemia due to high PTH levels leads to a deficiency of what mineral?

A

Phosphate

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5
Q

What is the cause of secondary HPT?

A

Complication of chronic renal disease

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6
Q

Tertiary HPT is seen in what population?

A

Dialysis patients

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7
Q

What is tertiary HPT?

A

When the parathyroid gland acts independently from serum calcium levels

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8
Q

HPT is more common in what gender and what age range?

A

Females aged 30-50

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9
Q

What are the symptoms of HPT?

A
  • -Bone pain,
  • -Fractures,
  • -Lethargy,
  • -Polyuria
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10
Q

What are the symptoms of hypercalcemia seen with HPT?

A

Muscle weakness and hypertonia

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11
Q

What elevated lab levels are seen with PTH?

A

Alkaline phosphatase and PTH

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12
Q

What GI complications can be seen with HPT?

A

Rengal stones, pancreatitis

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13
Q

What is the diagnostic and hallmark feature of HPT seen on X-ray?

A

Subperiosteal resorption

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14
Q

What is the term for the cystic accumulations of fibrous tissue commonly seen with HPT?

A

Brown tumor

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15
Q

What is the most common location for subperiosteal resorption that is seen with HPT?

A

RADIAL margins of the middle and proximal phalanges of the 2nd and 3rd digits

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16
Q

What unique dental feature is seen with HPT?

A

Loss of the lamina dura of the teeth

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17
Q

What kind of resorption is seen at the distal phalanges of the fingers with HPT?

A

Ungal tuft resorption

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18
Q

The SI involvement with HPT can resemble what other condition but what also sets it apart?

A

AS (if HPT, renal stones or kidney issues are likely present)

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19
Q

What radiographic features are more sensitive to hyperparathyroidism?

A

Rugger jersey spine, subperiosteal resorption at SI joints, salt-and-pepper skull

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20
Q

What is unique about the radiographic features of HPT following treatment?

A

Radiographic features disappear

21
Q

What causes the rugged jersey spine appearance in HPT?

A

Calcium deposits in vertebral endplates leading to sclerosis

22
Q

If bilateral symmetric SI joint widening and resorption is present, what 3 conditions could be assumed?

A

AS, enteropathic arthropathy, HPT (rule out with history)

23
Q

What is another name for a Brown tumor?

A

Osteoclastoma

24
Q

What causes the “brown” appearance of an osteoclastoma?

A

Hemosiderin from the focal hemorrhage

25
Q

What is the most common location for a brown tumor?

A

Can centrally happen anywhere (geographic)

26
Q

What hormones are released from the anterior pituitary? Posterior?

A
Anterior = GH, ACTH, TSH, FSH/LH, Prolactin
Posterior = ADH, oxytocin
27
Q

What type of tumor accounts for 10% of all neoplasms of the cranium?

A

Pituitary

28
Q

Autopsies have revealed that what percentage of the population actually have small pituitary adenomas?

A

25%!

29
Q

What are the general symptoms of a pituitary adenoma?

A

HEADACHES, visual disturbances, generalized discomfort in extremities

30
Q

What are the normal dimensions of the sella turcica?

A

12 mm depth, 16 mm sagittal plane

31
Q

How would we know if an enlarged sella turcica is only a normal variant in that patient?

A

No present symptoms

32
Q

Acromegaly and gigantism predispose an individual to what condition that larges impacts their skeletal system?

A

DJD (also a reduced lifespan)

33
Q

Acromegaly and gigantism primarily affect which body parts?

A

Hands and feet (acral parts)

34
Q

What causes acromegaly?

A

Over-secretion of growth hormone from a pituitary adenoma

35
Q

What does acromegaly mean?

A

“Large extremities”

36
Q

A pragmatic jaw is indicative of what condition?

A

Acromegaly

37
Q

What is the key difference between acromegaly and gigantism?

A

Acromegaly is not accompanied by an increase in height

38
Q

What are the radiographic features associated with acromegaly?

A

“Spade-like” distal tufts (phalanges), hooking osteophytes, increased tissue thickness

39
Q

The hooked osteophytes seen in acromegaly can be compared to what other condition?

A

Hemochromatosis (look at history)

40
Q

What radiographic feature of acromegaly can be seen on the skull X-ray?

A

Prominent frontal sinus and forehead

41
Q

What unique radiographic sign of acromegaly can be seen in the feet?

A

Increased heal pad thickness (normal is 8-12mm)

42
Q

What is the term for an enlarged tongue, commonly seen in acromegaly?

A

Macroglossia

43
Q

Which involves an over-secretin of growth hormone PRIOR to skeletal maturity: acromegaly or gigantism?

A

Gigantism (open physis)

44
Q

What is another name for Cushing’s disease?

A

Hypercortisolism

45
Q

What causes Cushing’s?

A

Increased production of cortisol or excessive use of cortisol or other steroid hormones

46
Q

What is the most common cause of hypercortisolism?

A

EXOgenous corticosteroid administration in patients requiring immunosuppression

47
Q

What is the most common cause of Cushing’s?

A

ENDOgenous over-secretion by ACTH, adrenal cortex, or tumor

48
Q

What are common visual signs seen in patients with Cushing’s?

A

“Moon face”, “buffalo hump”, accelerated hair growth, purple straie on abdomen, weight gain

49
Q

What serious bone complication can be seen in those with Cushing’s due to prolonged corticosteroid use?

A

AVN