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NBDE PART 1 MICRO/PATH > Micro/Path: Endocrine Disorders > Flashcards

Micro/Path: Endocrine Disorders Flashcards

1
Q

the most common pancreatic ENDOCRINE disorder

A

diabetes

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2
Q

diabetes is a __ disease involving mostly carbs (glucose) and lipids

A

metabolic

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3
Q

Diabetes Type __ is caused by an absolute deficiency of insulin

A

TYPE 1

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4
Q

Diabetes Type II is cause by

A

resistance to insulin’s action in peripheral tissues.

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5
Q

What is the classic triad of symptoms for DM?

A

polydipsia
polyuria
polyphagia

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6
Q

polydipsia

A

excessive thirst

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7
Q

polyphagia

A

excessive hunger aka hyperphagia

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8
Q

polyuria

A

excessive urination

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9
Q

Which is more common type I or type II DM

A

Type II is more common. 80-90% of diabetics

vs Type I = 10-20%

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10
Q

which diabetes is there no insulin secretion

A

Type I

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11
Q

in type II insulin secretion is __ or __

A

normal or exceeds normal

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12
Q
  1. DM Type I onset is in ___

2. DM Type II onset is in __

A
  1. childhood (juvenile diabetes)

2. adulthood

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13
Q
  1. Defect in type 1 dm?

2. Defect in type 2 dm?

A
  1. type 1 = destruction of B cells in pancreas that make insulin
  2. type 2 = reduced sensitivity of cells to insulin
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14
Q

One diabetes is associated with obesity and the other is not. which one is associated with obesity

A

Type 2 is associated with obesity. type 1 is not

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15
Q
  1. DM Type 1 - development of symptoms and onset is __

2. DM type 2 - development of symptoms and onset is __

A
  1. Type I = rapid

2. Type 2 = slow

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16
Q
  1. In which type of DM can ketosis occur if untreated
A
  1. type 1
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17
Q
  1. in which DM type 2 is ketosis common?
A

NO it is RARE

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18
Q

Treatment of DM type 1

A

insulin injection, diet management

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19
Q

treatment of type 2 DM

A

weight loss, diet management, occasional oral hypoglycemic drugs

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20
Q
  1. Acromegaly = excessive growth associated with the oversecretion of ______by the ___ .
  2. Does this occur in adult/child
  3. do the bones elongate or deform?
A
  1. Growth hormone by the ANTERIOR pituitary
  2. adult usually b/w 35-55years old LONG after the end plates of bones have closed.
  3. THEY DO NOT ELONGATE bc the end plates have already closed. They instead deform
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21
Q

Acromegaly commonly:

  1. ___ of head, face, hands, feet and chest
  2. excessive ___ and offensive ___
  3. Mandible ___
  4. Tongue ___
  5. __ voice
A
  1. Gradual marked enlargement: The cheekbones are pronounced, the forehead bulges, the jaw is enlarged and facial lines prominent
  2. perspiration, body odor
  3. protrudes (Prognathism)
  4. tongue enlarged
  5. deep voice
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22
Q
  1. Pituitary Gigantism - oversecretion of GH during __ before ___
  2. Leads to __ and __
A
  1. childhood, before end plates of long bones close

2. bone growth and abnormal height

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23
Q
  1. __ a syndrome that results when the anterior pituitary gland produces excess growth hormone (GH) after epiphyseal plate closure at puberty.
  2. __ excessive growth from oversecretion of GH during childhood
A
  1. acromegaly

2. pituitary gigantism

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24
Q
  1. ___ =arrested growth, these people have limbs and features not properly proportioned or formed.
A

Dwarfism AKA pituitary dwarfs

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25
Q
  1. This condition is caused by UNDERSECRETION of GH

2. Name 2 conditions associated with OVERSECRETION OF GH

A
  1. Dwarfism

2. acromegaly and pituitary gigantism

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26
Q

the most common thyroiditis and most common cause of HYPOTHYROIDISM is

A

Hashimoto’s thyroiditis

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27
Q

Hashimoto’s thyroiditis is a __ disorder

A

autoimmune

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28
Q

etiology means

A

cause

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29
Q
  1. what is the reason for hashimoto’s thyroiditis?
  2. there is a __ infiltration with __ formation
  3. it is most common in __ (w/m old or young population) and tends to __
  4. it may occur in people with certain __ abnormalities such as __
  5. there is an increased incidence seen in people with (3)
A
  1. unknown reasons, autoimmune reaction occurs, antibodies form that attack the thyroid gland.
  2. DIFFUSE LYMPHOCYTIC INFILTRATION, GERMINAL CENTER
  3. elderly women and tends to run in families
  4. chromosomal ie. turner’s, down syndrome, klinefelters syndrome.
  5. pernicious anemia, diabetes, Sjogren’s
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30
Q

IF someone has hypothyroidism the most common cause is ?

A

Hahimoto’s Thyroiditis (autoimmune)

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31
Q

Symptoms of hypothyroidism

A

fatigue, slowed speech, cold intolerance, dry skin, coarse hair and puffy skin

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32
Q
  1. Subacute Granulomatous Thyroiditis aka

2. probably caused by a __ beginning much more __ than Hashimoto’s thyroiditis

A
  1. Giant cell

2. virus, sudden

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33
Q
  1. silent lymphocytic thyroiditis: occurs most often in men/women?
A

women JUST AFTER CHILDBIRTH causing thyroid to enlarge w/o becoming tender. most people recover completely

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34
Q
  1. which two types of thyroiditis can people recover completely from ? which cant you recover from?
  2. which is the most common form of thyroiditis?
A
  1. recover from subacute granulomatous and silent lymphocytic. but not hirashimoto thyroiditis
  2. hirashimoto
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35
Q

Autoimmune diseases = resulting from an immune reaction produced by body’s __ or __ acting on the body’s own tissues

A

WBC or antibodies

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36
Q
  1. A lymphocyte is any of 3 types of ___in a vertebrate’s immune system.
  2. All 3 are agranulocytes/granulocytes?
  3. What cells?
    They are the main type of cell found in lymph, which prompted the name lymphocyte.
A
  1. white blood cell
  2. agranulocytes.
  3. natural killer cells (NK cells) (which function in cell-mediated, cytotoxic innate immunity)

T cells (for cell-mediated, cytotoxic adaptive immunity),

B cells (for humoral, antibody-driven adaptive immunity).

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37
Q

In Hashimoto’s disease there is a production of antibodies in response to thyroid antigens and the replacement of

A

normal thyroid structure with lymphocytes and lymphoid germinal centers

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38
Q

____ any condition where there is too much thyroid hormone = ___

A

hyperthyroidism (thyroxin T4)

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39
Q
  1. Name the 2 thyroid hormones,
  2. What amino acid are they formed from?
  3. the hormones are primarily responsible for regulation of?
  4. ___ is necessary for the production of T3 and T4.
  5. A deficiency of __ leads to decreased production of T3 and T4, enlarges the thyroid tissue and will cause the disease known as goitre.
  6. The major form of thyroid hormone in the blood is ___
  7. why?
  8. The ratio of T4 to T3 released into the blood is roughly 20 to 1. Which one is active hormone?
A
  1. triiodothyronine (T3) and thyroxine (T4),
  2. tyrosine
    3.metabolism.
  3. iodine
  4. iodine
  5. thyroxine (T4),
  6. has a longer half-life than T3.
    8.T3 is the active
    (T4 is converted to the active T3)
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40
Q
  1. hyperthyroidism is most commonly due to ___

2. hypothyroidism is most commonly due to __

A
  1. Grave’s Disease

2. Hashimoto’s Thyroiditis

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41
Q
  1. Grave’s disease aka
A

diffuse toxic goiter

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42
Q
  1. ___ disease is the general overactivity of the thyroid gland
  2. __ disease = one or more nodules/lumps in the thyroid being overactive
A
  1. Grave’s disease (diffuse toxic goiter)

2. Plummer’s Disease (nodular Toxic Goiter)

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43
Q
  1. primary role of thyroxin (T4) is to stimulate?
A
  1. metabolism, growth, and differentiation of all tissues.
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44
Q

If T4 is in excess:

  1. ___ basal metabolism
  2. weight ___
  3. __ temperature
  4. generalized ___
A
  1. high
  2. loss
  3. elevated
  4. generalized osteoporosis
    fatigue
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45
Q

hyperthyroid or hypothyroid associated with oseteoperoisis

A

hyperthyroid (Graves/Plummers disease)

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46
Q

if hyperthyroidism occurs early in life the effect on teeth:

  1. __ eruption of teeth
  2. ___loss of deciduous teeth
A
  1. premature

2. premature

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47
Q
  1. in rickets = __ eruption of teeth
  2. in pagets = of teeth
    3, in hyperthyroidism =
A
  1. delayed eruption, malocclusion, dentin and enamel abnormal development
  2. teeth spread
  3. premature eruption and loss of primary teeth
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48
Q
  1. Symptoms of hyperthyroidism (excessive T4)

2. symptoms of hypo?

A
  1. increased perspiration (heat intolerance), nervousness, irritability, fine brittle hair, muscular weakness, weight loss despite of good appetite, tremor, diarrhea, tachycardia (rapid heart rate)
  2. fatigue, cold intolerance, slowed speech, dry skin, coarse hair, puffy face and eyelids, swelling of tongue, poor muscle tone, low metabolic rate and body temp, low strength, tire easy, mentally sluggish, depression, increased weight gain, dry itchy skin, muscle cramps, constipation
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49
Q
  1. name the 2 types of hyperthyroidism

2. which is the most common type

A
  1. graves (diffuse goiter) and plummers (nodular goiter)

2. graves

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50
Q
  1. __ (hyperthyroid) occurs most frequently in women under the age of 50.
  2. occurs in both men and women usually over the age of 50
A
  1. graves

2. plummers

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51
Q

Exophthalmos?

A

also called exophthalmia or proptosis, is a bulging of the eye anteriorly out of the orbit

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52
Q

which type of hyperthyroidism is exophthalmos common? which one is it rare

A
  1. common in graves

rare in plummers

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53
Q

which type of hyperthyroidism affects multiple body systems? which one affects one system (uni system)

A
  1. graves = multiple systems

2. plummers - one system unisystem

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54
Q

hypothyroidism = _ hormone is below normal

A

T4 thyroxine

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55
Q

Which is more common, hypothyroidism or hyperthyroidism

A

hypo is MUCH more common and is the most common form of abnormal thyroid function.

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56
Q

hypothyroidism is much more common in men or women

A

women

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57
Q

The most common cause of hypothyroidism is __

the second most common is?

A 
1st = hiroshimoto thyroiditis
2nd = from treating hyperthyroidism
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58
Q
  1. hyper or hypothyroid the tongue swells
  2. hyper or hypothyroid constipation
  3. hyper or hypothyroid diarrhea
  4. low metabolic rate and temp in?
A
  1. hypo
  2. hyper (think SNS)
  3. hypo (think PNS)
  4. hypo = think low
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59
Q
  1. dental findings in hypothyroid in a child?
A
  1. underdeveloped mandible, overdeveloped maxilla, enlarged tongue that can lead to malocclusion, delayed tooth eruption, and deciduous teeth retained longer
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60
Q
  1. if ___(hyper/hypothyroid) occurs early in life the effect on teeth premature eruption of teeth and loss of deciduous teeth
  2. in hypo, tooth eruption and teeth
  3. which one = occlusion probs
A
  1. hyper
  2. retained longer
  3. hypo
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61
Q
  1. Cretinism = severe __ in a child/adult
  2. due to?
  3. result
  4. if cretinism is recognized early it can be markedly improved by
A
  1. HYPOthryroid in a child (think C = child)
  2. lack of thyroxine hormone
  3. abnormal bone development, growth and mental retardation, improper CNS development
  4. thyroxine hormones
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62
Q
  1. Myxedema =

2. MORE COMMON IN MEN OR WOMEN

A

extreme/sever hypothyroidism in adults.

2. WOMEN

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63
Q

severe hypothyroidism in child is called?

in adult it is called?

A

cretinism

myxedema

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64
Q

treatment of both cretinism and myxedema

A

administer thyroxine hormone

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65
Q

hypothyroidism clinical feature is

A

WEIGHT GAIN cold intolerance, lowered pitch of voice, mental and physical slowness, constipation, dry skin, coarse hair, puffiness of hands, eyes, and face

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66
Q

Dental findings in a child with hypothyroidism (cretinism): 1. __ tongue

  1. __ mandible
  2. __ maxilla
  3. __ eruption of teeth and exfoliation of teeth
A
  1. large
  2. underdeveloped
  3. overdeveloped
  4. delayed

large tongue, large maxilla, small mandible, delayed eruption of teeth and retain primary teeth longer

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67
Q

A common complication associated with hypePARArthyroidism is?

A

kidney stones (renal calculi)

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68
Q

why do kidney stones form

A

due to excessive excretion of calcium and phosphate

69
Q

Osteoperosis, giant cell granuloma, and metastatic calcifications are all manifestations of?

A

hyperPARAthyroidism

70
Q

other factors that contribute to kidney stone formation:

  1. vitamin __ deficiency
  2. low __ intake
  3. diet too high in
  4. _ problems
A

1, A

  1. fluid
  2. calcium
  3. metabolic
71
Q

Metastatic Calcification - the deposition of calcium salts in ____ tissues due to excess calcium in blood and occurs particulary In what 2 conditions (2)

A

previously undamaged

hyperparathyroidism and hypervitaminosis D

72
Q

Dystrophic calcification - the most frequent type of pathologic calcification where calcium salts are deposited in ___ tissues . it is secondary to the disease of the tissue affected

A

dead or degenerating

73
Q
  1. Calcinosis: calcifications located?

2, often associated with?

A
  1. skin

2. scleroderma and dermatomyositis

74
Q

Primary Hyperparathyroidism = major cause is?

75
Q

what is an adenoma

A

a benign tumor of gallbladder epithelium

76
Q

In primary hyperparathyroidism:

  1. serum phosphorous __
  2. serum alkaline phosphatase
  3. serum PTH
A
  1. decreases
  2. increase
  3. increase
77
Q

Name 2 diseases in which serum alkaline phosphatase increases and phosphorous decreases

A 
primary hyperparathyroidism = increase pth as well
Von Recklinghausen (osteitis fibrosa cystica) = increased calcium,
78
Q

name 3 diseases that have increase serum alkaline phosphatase

A

Von Recklinghausen, primary hyperparathyroidism, Paget’s (normal Ca and phosphorous)

79
Q

clinical characteristics of primary hyperparathyroidism?

A

cystic bone lesions (osteitis fibrosa cycstica) nephrocalcinosis, kidney stones, and peptic duodenal ulcers

80
Q
  1. The parathyroid glands are small endocrine glands in the __ of humans that produce parathyroid hormone. 2. 2. Humans usually have __ # parathyroid glands, variably located on the __ of the thyroid gland
  2. Through production and regulation of parathyroid hormone, the parathyroid glands affect the amount of ___ in the blood and within the bones
  3. The glands are derived from the ___brachial arches, 5. with the superior glands arising from the__ arch,
  4. and the inferior glands arising form the __ arch.
    This is a result of an artefact of embryological development, whereby the inferior glands are dragged down alongside the third brachial arch.
  5. are they palpable/visible by clinician
  6. what cells synthesize PTH
A
  1. neck (pea sized)
  2. 4, back
  3. calcium
  4. third and fourth
  5. fourth
  6. third
  7. These glands are not visible or palpable during extraoral examination of a patient
  8. chief cells
81
Q

Calcitonin (also known as thyrocalcitonin) is produced in humans primarily by the ___ cells of the ___

A

parafollicular cells (also known as C-cells) of the thyroid,

82
Q

The major function of the parathyroid glands is to maintain the body’s ____levels within a very narrow range, so that the ___systems can function properly.

A
  1. calcium and phosphate

2. nervous and muscular

83
Q
  1. PTH___blood calcium levels by stimulating ____ to break down bone and release calcium.
  2. PTH also increases gastrointestinal calcium ____by activating ____, and promotes calcium ___by the kidneys
A
  1. increases, osteoclasts

2. absorption, vitamin D, conservation (reabsorption)

84
Q
  1. PTH is the major regulator of serum phosphate concentrations via actions on the ___.
  2. It is an ___of proximal tubular reabsorption of phosphorus. Through activation of Vitamin D the absorption of Phosphate is increased
A
  1. kidney

2. inhibitor

85
Q
  1. Renal disease may also lead to ____
  2. When too much calcium is lost, there is a compensation by the parathyroid, and parathyroid hormone is released. The glands ___to synthesise more parathyroid hormone.
  3. This is also known as ___ hyperparathyroidism
A
  1. hyperparathyroidism.
  2. hypertrophy
  3. secondary
86
Q
  1. Hyperparathyroidism is the state in which there is excess parathyroid hormone circulating. This may cause bone pain and tenderness, due to increased bone reabsorption. Due to increased circulating calcium, there may be other symptoms associated with hypercalcemia, most commonly dehydration. Hyperparathyroidism is most commonly caused by a benign proliferation of ___
  2. This is known as___hyperparathyroidism
A
  1. Chief cells.

2. primary

87
Q

__ hyperparathyroidism is a metabolic disorder where one or more of the 4 glands produce too much PTH causing too much calcium to be released from bone into blood.

88
Q

when ONE parathyroid gland enlarges the condition is known as

89
Q

when >1 Parathyroid gland enlarges the condition is known as

A

hyperplasia

90
Q
  1. An adenoma = is a benign/malignant tumor of ___ tissue with ___origin, glandular characteristics, or both.

Adenomas can grow from many glandular organs, including the adrenal glands, pituitary gland, thyroid, prostate, and others

A
  1. BENIGN tumor of epithelial tissue with GLANDULAR ORIGIN
91
Q

Although adenomas are benign, over time they may transform to become malignant, at which point they are called ___

A

adenocarcinomas

92
Q

adenocarcinoma and adenomas are both ___

A

epithelial of glands

93
Q
  1. hypertrophy is an increase in cell ___
  2. hyperplasia involves an increase in the ___ of cells.
  3. hypoplasia
A
  1. size
  2. number
  3. underdevelopment or incomplete development of a tissue or organ
94
Q

primary hyperparathyroidism is seen more in men or women

A

2x more in women

95
Q
  1. symptoms of primary hyperparathyroidism

2. __ may be the first symptom

A
  1. appetite loss, thirst, polyuria, lethargy, fatigue, muscle weakness, joint pain, constipation.
  2. pathological fracture doe to marked bone resorption
96
Q

Oral manifestations of primary hyperparathyroidism:

  1. diffuse bone __
  2. teeth __
  3. appearance of __ on xrays in posterior area of the jaw with ___ appearance and lost lamina dura around the roots
A
  1. loss
  2. shifting and malocclusion
  3. cystic like radiolucencies (central giant cell lesions)
    GROUND GLASS APPEARANCE
97
Q

any patient with a lesion diagnosed as a __ should be evaluated to rule out possible hyperparathyroidism

A

central giant cell lesion.

98
Q

what conditions present giant cell lesions:

A

fibrous dysplasia, central and peripheral giant cell granuloma, paget’s disease

99
Q

hypoparathyroidism is most commonly caused by

A

accidental surgical excision during thyroidectomy

100
Q

hypoparathyroidism in rare instances is associated with

A

congenital thymic hypoplasia (DiGeorge’s Syndrome)

101
Q

hypoparathyroidism = causes calcium levels to __ due to decreased

A

calcium, PTH

102
Q

a common symptom of low plasma calcium level is

A

tingling of extremities and skeletal muscle twitching

103
Q

if plasma calcium level is low enough, skeletal muscle __ may occur

A

spasms (tetany)

104
Q

causes of decreased blood calcium: genetic, congenital absence of PT gland, surgical removal by accident, massive radiation, or __ deficiency

105
Q

HYPOPARAthyroidism dental manifestations:

  1. __ eruption of teeth,
  2. __ root apices
  3. enamel ___
  4. the dental manifestations can be prevented by EARLY treatment with?
A
  1. delayed
  2. blunted
  3. hypoplasia
  4. vitamin D
106
Q

___ - involves a defective end organ responsiveness to PTH

A

pseudoparathyroidism

107
Q

Addison’s Disease aka

A

adrenocortical insufficiency

108
Q
  1. Addison’s Disease is a life threatening condition caused by
  2. may be the result of?
  3. Over __% of the adrenal cortex must be destroyed before obvious symptoms occur
  4. age? m/f?
A
  1. partial/complete failure of adrenocortical function.
  2. autoimmune, infection, neoplasm, hemorrhage of a gland
  3. 90%
  4. any age, equally m and w
109
Q

Addison’s is characterized by __ of skin

110
Q

oral signs of Addison’s:

A

diffuse pigmentation of gingiva, tongue, hard palate, and buccal mucosa. MELANOSIS is common manifestation

111
Q

how is Addison treated

A

administering cortisol (hydrocortisone) = Prednisone is a synthetic corticosteroid drug that is particularly effective as an immunosuppressant drug

112
Q

in __% of pp with addisons, the adrenal glands are destroyed by cancer, amyloidosis, an infection like TB, or another disease

113
Q

in 70% of pp with addisons the cause is ___ but is suspected that the adrenal glands are destroyed by an __

A

unknown, autoimmune Reaction

114
Q

Addison’s is characterized by:

  1. hyper/hypotension
  2. serum levels of NaCl and HCO3- are __
  3. serum levels of K+ are
A

HYPOTENSION
ASTHENIA (weakness)
increased pigmentation of skin and oral mucous membrane, and low levels of sodium, chloride, and bicarbonate with elevation in potassium
nausea and vomiting

115
Q

Cushing’s syndrome is a __ disorder caused by prolonged exposure of body tissues to high levels of ___

A

hormone, cortisol hormone

116
Q

Cushing’s syndrome is relatively rare and commonly affects adults 20-50years. Symptoms are

A

upper body obesity, round face, increased fat around neck “BUFFALO HUMP” MOON FACE, diabetes, obesity, abnormal fat deposition, muscle wasting, osteoporosis, and thinning of arms and legs

117
Q

Ectopic cushing syndrome - usually caused by secretion of __

A

bronchogenic carcinoma and pancreatic neoplasms.

118
Q

Gout = sudden recurring attacks of

A

very painful arthritis

119
Q

Gout is caused by deposition of

A

monosodium urate crystals that accumulate in joints b/c of abnormally high uric acid level in blood (HYPERURICEMIA)

120
Q

Gout is an ___ disorder of ___ metabolism

A

inherited, purine

121
Q

uric acid is the end product of __ metabolism

A

purine (xanithine metabolism)

122
Q

gout is mostly seen in m/w

123
Q

gout most often affects which joint

A

the joint at the base of the big toe - condition is called PODAGRA

124
Q

Gout: hard lumps of urate crystals called ___ are deposited under __ around joints

A

TOPHI, skin

125
Q
  1. the enzyme that add PHOSPHATES

2. the enzyme that removes PHOSPHATES

A
  1. kinase adds

2. phosphatase removes

126
Q
  1. which can cross the cell membrane easily: peptide hormone or steroid hormone?
  2. which one gets catabolized in the GI tract and which one can cross?
  3. How are peptide hormones administered?
  4. which has a shorter half life
  5. how do they enter the cells?
A
  1. steroid hormone can cross because it is fat soluble. Peptide hormones are water soluble.
  2. peptide hormones are catabolized in GI tract.
  3. they can’t absorb skin well so they are given by injection.
  4. peptide hormones have a shorter half life
  5. peptide binds to G-protein coupled receptors
    steroid hormones go thru to cytoplasm and into nucleus
127
Q

which hormone is produced more during the night when you sleep and which is produced more during the day? Growth hormone/cortisol

A

Growth hormone produced mostly at night when you are asleep. Cortisol is higher during the day

128
Q

endocrine disorders are more common in men or women

129
Q

endocrine disorders are often __ disorders.

are they hereditary?

A
  1. autoimmune

2. yes often hereditary

130
Q
  1. Men and women produce the same/different hormones yet they produce diff effects.
  2. They are named for what they do in men/women
  3. They are made in ___ amounts in men and women. They modulate diff things depending on their pulse releases.
A
  1. same
  2. women
  3. diff
131
Q 
Name the hormone
Ca -- 
Cr --
CRH -- 
DHT -- DHEA (or DHEA-S) --
A

Ca – calcium
Cr – creatinine
CRH – corticotropin releasing hormone

DHT – dihydrotestosterone
DHEA (or DHEA-S) – dehydroepiandrosterone (or dehydroepiandrosterone sulfate)

132
Q

Name the hormone

ACTH –
ADH –
AMS –aka MIS

A

ACTH – adrenocorticotropic hormone
ADH – antidiuretic hormone
AMS –antimullerian substance = MIS = mullerian inhibiting substance

133
Q 
T3 -- 
T4 -- 
TRH -- 
TSH --
TSI –
A 
T3 -- triiodothyronine
T4 -- thyroxine
TRH -- thyrotropin releasing hormone
TSH -- thyroid stimulating hormone
TSI – thyroid stimulating immunoglobulin
134
Q

PTH –
PTHrP –
PO4 –

A

PTH – parathyroid hormone
PTHrP – parathyroid hormone - related peptide
PO4 – phosphate (used interchangeably with phosphorous)

135
Q

FSH -
GH –
GHRH –
GnRH -

A

FSH - follicle stimulating hormone

GH – growth hormone
GHRH – growth hormone releasing hormone
GnRH - gonadotrophic hormone releasing hormone

136
Q

HCG –

IGF-1 –
IGF-II –
IGT –

K –
LH –

Na –

A

HCG – human chorionic gonadotropin

IGF-1 – insulin-like growth factor -1
IGF-II – insulin-like growth factor-II
IGT – impaired glucose tolerance

K – potassium

LH – luteinizing hormone

Na – sodium

137
Q

Peptide Hormones:

  1. Attach to receptors where?
  2. Activate _ and _
  3. Makes changes in cells?
  4. ___soluble
  5. __in GI tract and ___ absorbed from skin
  6. __ half life
A
  1. on cell surface
  2. activate G protein and kinases
    subsequent 2nd messengers
  3. changes in cell calcium/phosphorylation state, cell secretion and protein synthesis
  4. water
  5. catabolized in GI and poorly absorbed by skin
  6. short half life
138
Q

Steroid hormone

  1. Attach to receptors where?
  2. hormone-receptor complex interacts with
  3. changes __ synthesis
  4. ___soluble
  5. __in GI tract and ___ absorbed from skin
  6. __ half life
A
  1. Enter cell cytoplasm and nucleus. interact with receptors in cytoplasm and nucleus
  2. DNA
  3. Fat
  4. Absorbed in GI and from skin
    5.
139
Q

Name the 4 Hypothalamus hormones

A

CRH, GHRH, GnRH, TRH

140
Q

Name the ANTERIOR PIT HORMONES

A 
FLAT PEG:
FSH
LH
ACTH
TSH
Prolactin (somatomammotropin)
Endorphins
141
Q

Adrenal or Gonadal Hormones?

A 
Aldosterone 
cortisol
dehydroepiandrosterone
progesterone
testosterone
dihydrotestosterone
estradiol
142
Q

posterior pituitary hormones?

A

ADH (vasopressin) and oxytocin

143
Q

what kind of vit D do we make from exposure to sunlight

A

vitamin D3 cholecalciferol (this is not the active kind)

144
Q

Vitamin D is activated in?

A

liver and kidney

145
Q

Vitamin D is stored in

146
Q

Vit D1,25 (OH)2 will do what?

A

increase Phosphourous absorbtion and Calcium absorption

147
Q

what is the active form of vitamin D

A

vitamin D 1,25 (OH)2 = increases calcium and PO4 absorption

1,25 dihydroxy vitamin D

148
Q

Vitamin D is what kind of hormone? Is it more a hormone or a vitamin

A

steroid hormone. more a hormone bc we can make it, so it is not a true vitamin.

149
Q

to regulate calcium we need __ glands

A

parathyroid

150
Q

name 4 hormones that regulate calcium

A

PTH, PTHrP (parathyroid hormone related peptide), calcitonin, 1,25 dihydroxy vitamin D

151
Q

PTH acts on __ and __

A

kidneys and bones

152
Q

in bone, PTH will

A

increase resorption and release of calcium and phosphorous by increasing osteoclast action

153
Q

in kidneys PTH will stimulate __ enzyme? why

A

1 alpha hydroxylase b/c enzyme needed to make active Vit D.

154
Q

what is the enzyme that converts 25 vitamin D to the active form 1,25 Vit D3?

A

1 alpha hydroxylase LOCATED IN THE KIDNEYS

155
Q

PTH affect on the renal tubules:

  1. __ calcium excreted
  2. ___ PO4 excreted
  3. increase formation of
A
  1. decrease calcium excreted
  2. increase po4 excreted (because if we make lots of calcium phosphorous should be low otherwise we turn into stone CaPO4
  3. 1 alpha hydroxylase to make more active vit d so we can absorb calcium
156
Q

PTHrP plays a role in?

157
Q

PTHrP:

  1. can it activate Vit D?
  2. it will __ calcium
  3. It will __ PO4
  4. It will __ PTH
  5. what receptors does it bind
A
  1. no.
  2. it acts like PTH in the sense that it increases calcium
  3. it decreases PO4
  4. DECREASES PTH
  5. binds the same receptors as PTH on bone and kidney
158
Q

calcitonin made where

A

in thyroid follicular cells

159
Q
  1. receptors for calcitonin are on ___. they will decrease __ activity
A
  1. on osteoclasts, decrease osteoclast activity
160
Q

receptors for PTH are on __

A

osteoblasts (decrease their activity)

161
Q

do we need thyroid to regulate calcium

162
Q

IF calcium levels are high:
PTH levels will
increase excretion of __
and decrease excretion of __

A

PTH DROPS
CA EXCRETION INCREASES
AND PO4 DECREASE EXCRETION.

163
Q

IF calcium levels are low:
PTH levels will
increase excretion of __
and decrease excretion of __

A

PTH WILL INCREASE
CA EXCRETION DECREASES
PHOS EXCRETION INCREASES

164
Q

PTH ___ the reabsorption of phosphate from the proximal tubule of the kidney, which means more phosphate is excreted through the urine.

165
Q

osteoid means

A

unmineralized bone

166
Q
  1. in primary/secondary hyperparathyroidism, calcium levels are low
A
  1. secondary (it is a response to low calcium levels that more PTH is made)
167
Q
  1. in in primary/secondary hyperparathyroidism, calcium levels are high
A
  1. in primary hyperparathyroidism PTH and calcium are high
168
Q

in primary hyperparathyroidism the problem is ___

A

parathyroid adenoma is producing high PTH. and thus the high PTH is causing high calcium

169
Q

In secondary hyperparathyroidism the problem is ___

A

low blood calcium due to low vit D or kidney failure, so PTH increases. PTH is secondary to low calcium.

NBDE PART 1 MICRO/PATH (20 decks)

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