Lecture 7- Endocrine pathology 2 Flashcards
a decreased level of blood calcium stimulates the synthesis and release of
PTH
actions of PTH
increases tubular reabsorption of calcium
increases urinary phosphate excretion
increase renal conversion of vit. D into its active form
increase osteoclastic acitivty which releases calcium from the bones
net effect of PTH
increase level of free calcium which inhibits further PTH secretion
hyperparathyroidism is an important cause of…. and is caused by excess secretion of…
hypercalcemia
PTH
2 types of hyperparathyroidism
primary- autonomous spontaneous overproduction of PTH
secondary- pts with chronic renal failure
classic clinical features of primary hyperparathyroidism
painful bones- fractures
stones- kidney
abdominal groans- constipation, peptic ulcers, gallstones
psychic moans- depression, lethargy, seizures
2 oral manifestations of hyperparathyroidism
ground glass appearance
brown tumor
Secondary hyperparathyroidism:
renal insufficiency leads to …. which decreases serum calcium levels thereby stimulating PTH
damaged kidneys are also unable to produce… which reduces calcium absorption in intestines which stimulates PTH
hyperphosphatemia
vitamin D
hypoparathyroidism is uncommon but has 3 causes
surgically induced by removal during thyroidectomy
congenital absence (diGeorge)
autoimmune
clinical features of hypoparathyroidism
hypocalcemia
increased neuromuscular excitability
cardiac arrythmias
increased intracranial pressures and seizures
the endocrine pancreas is composed of the ….which are microscopic clusters of cells which include beta, alpha, delta, and PP cells
islets of langerhans
beta cells produce…
insulin
alpha cells produce…
glucagon
delta cells produce…
somatostatin
PP cells produce …
VIP, a pancreatic polypeptide
Diabetes diagnosis: random glycemia level is greater than… with classical S&S or a fasting glucose level of greater than … on more than one occasion or an abnormal glucose tolerance test
200 mg/dL
126 mg/dL
symptoms of type 1 diabetes once 90% of the beta cells are destroyed
polydipsia
polyuria
polyphagia
ketoacidosis
what is responsible for 80% of DM related deaths
vasculopathy (MI, stroke, atherosclerosis, gangrene of LL)
2 types of hyperadrenalism
hypercortisolism (cushing)
hyperaldosteronism
short term clinical features of cushings
weight gain and HTN
“moon facies”
“buffalo hump”
long term clinical features of cushings
decr. muscle mass/ weakness
diabetes
osteoporosis
hirutism
mental disturbances
mentrual irreg.
