Lecture 7- Endocrine pathology 2

Question 1

a decreased level of blood calcium stimulates the synthesis and release of

Answer 1

PTH

Question 2

actions of PTH

Answer 2

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

Question 3

net effect of PTH

Answer 3

increase level of free calcium which inhibits further PTH secretion

Question 4

hyperparathyroidism is an important cause of…. and is caused by excess secretion of…

Answer 4

hypercalcemia

PTH

Question 5

2 types of hyperparathyroidism

Answer 5

primary- autonomous spontaneous overproduction of PTH

secondary- pts with chronic renal failure

Question 6

classic clinical features of primary hyperparathyroidism

Answer 6

painful bones- fractures

stones- kidney

abdominal groans- constipation, peptic ulcers, gallstones

psychic moans- depression, lethargy, seizures

Question 7

2 oral manifestations of hyperparathyroidism

Answer 7

ground glass appearance

brown tumor

Question 8

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

Answer 8

hyperphosphatemia

vitamin D

Question 9

hypoparathyroidism is uncommon but has 3 causes

Answer 9

surgically induced by removal during thyroidectomy

congenital absence (diGeorge)

autoimmune

Question 10

clinical features of hypoparathyroidism

Answer 10

hypocalcemia

increased neuromuscular excitability

cardiac arrythmias

increased intracranial pressures and seizures

Question 11

the endocrine pancreas is composed of the ….which are microscopic clusters of cells which include beta, alpha, delta, and PP cells

Answer 11

islets of langerhans

Question 12

beta cells produce…

Answer 12

insulin

Question 13

alpha cells produce…

Answer 13

glucagon

Question 14

delta cells produce…

Answer 14

somatostatin

Question 15

PP cells produce …

Answer 15

VIP, a pancreatic polypeptide

Question 16

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

Answer 16

200 mg/dL

126 mg/dL

Question 17

symptoms of type 1 diabetes once 90% of the beta cells are destroyed

Answer 17

polydipsia
polyuria
polyphagia
ketoacidosis

Question 18

what is responsible for 80% of DM related deaths

Answer 18

vasculopathy (MI, stroke, atherosclerosis, gangrene of LL)

Question 19

2 types of hyperadrenalism

Answer 19

hypercortisolism (cushing)

hyperaldosteronism

Question 20

short term clinical features of cushings

Answer 20

weight gain and HTN

“moon facies”

“buffalo hump”

Question 21

long term clinical features of cushings

Answer 21

decr. muscle mass/ weakness

diabetes

osteoporosis

hirutism

mental disturbances

mentrual irreg.