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NYCC Visceral Pathology > Parathyroid & Adrenal Gland Pathology > Flashcards

Parathyroid & Adrenal Gland Pathology Flashcards

1
Q

Hyperparathyroidism will present with (Hypercalcemia/Hypocalcemia)?

A

Hypercalcemia

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2
Q

Hypoparathyroidism will present with (Hypercalcemia/Hypocalcemia)?

A

Hypocalcemia

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3
Q

What is the number one cause of primary hyperparathyroidism?

A

Parathyroid adenoma

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4
Q

What are signs and symptoms of hypercalcemia?

A

Lethargy, dulled mentation, hyporeflexia, stomach pains (peptic ulcer), loin to groin pain (Renal stone), acute pancreatitis

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5
Q

What are signs and symptoms of hypocalcemia?

A

Tetany, laryngeal spasms, hyperreflexia, anxiety, paranoia

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6
Q

39 year old male patient presents to your office complaining of excessive stomach pain and pain radiating from his loin to his groin. Notable in the Pt Hx. Is that he recently had his thyroid removed due to a catastrophic throat chop incident at his last karate tournament. Recently, he notes being fatigued at work. Blood tests show calcium levels of 11.1 mg/dl. Radiograph shows evidence of kidney stones in the right kidney. What is the likely diagnosis based on this information?

A

Parathyroid adenoma causing primary hyperparathyroidism

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7
Q

What is the most common cause of secondary hyperparathyroidism?

A

Renal failure

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8
Q

What is the pathogenesis of secondary hyperparathyroidism?

A

Low calcium retention or absorption causes the parathyroid gland to undergo hyperplastic changes to increase PTH

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9
Q

What is the most common cause of hypoparathyroidism?

A

Iatrogenic surgical removal of the parathyroids often due to a thyroidectomy

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10
Q

High CSF and papilledema are indicative signs of (Hypocalcemia/Hypercalcemia)?

A

Hypocalcemia

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11
Q

How are patients with hypoparathyroidism treated?

A

Vitamin D and calcium supplementation

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12
Q

What orthopedic tests/signs are indicative of hypocalcemia if positive?

A

Troussea’s sign, Chvostek’s sign, and carpopedal spasm

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13
Q

What are examples of adrenal cortex pathologies?

A

Congenital adrenal hyperplasia
Cushing syndrome
Conn syndrome
Addison disease

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14
Q

What is an example of an adrenal medulla pathology?

A

Pheochromocytoma

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15
Q

How does congenital adrenal hyperplasia occur?

A

Hydroxylase 11,17, or 21 congenital anomaly that interrupts the biosynthesis of cortisol resulting in an increase in androgens

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16
Q

9 year old male patient presents to your office. The mother is complaining that the son is experiencing growing pains despite his early age. He seems to have hit an early growth spurt. Blood test shows high levels of androgens. When you inquire to the mother about any relevant medical history, she jokes that they had a hard time determining if he was a boy or a girl at birth. What is the likely diagnosis?

A

Congenital adrenal hyperplasia

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17
Q

Newborn female presents to the maternity ward. The female newborn has a grossly enlarged clitoris and virilization. Her levels of ACTH are high and her circulating aldosterone and cortisol levels are low. What is the likely diagnosis?

A

Congenital adrenal hyperplasia

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18
Q

What is the number one cause of Cushing’s Syndrome in the US?

A

Exogenous corticosteroid use

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19
Q

What is the number one cause of Cushing’s Disease?

A

Pituitary corticotrope tumor

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20
Q

The defining feature of Cushing’s syndrome is ____

A

Hypercortisolemia

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21
Q

What are signs and symptoms of Cushing’s?

A

Purple striae
Moon face
Truncal obesity
Hirsutism
Buffalo hump
Hypertension
Decreased lymphocytes
Osteoporosis
Wasting of limbs
Atherosclerosis

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22
Q

What is the number one predictor of atherosclerosis?

A

Hyperglycemia

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23
Q

What is Conn syndrome?

A

Primary hyperaldosteronism due to an aldosterone producing adenoma

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24
Q

A patient with Conn syndrome will have (Hyper/Hypo) natremia?

A

Hyper

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25
Q

A patient with Conn syndrome will have (Hyper/Hypo) tension?

A

Hyper

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26
Q

A patient with Conn syndrome will have (Hyper/Hypo) kalemia?

A

Hypo

27
Q

35 year old male patient presents to your office complaining of frequency urination, fatigue, and headaches. Blood pressure measures 155/100. Blood test shows hypernatremia and hypokalemia. Cortisol levels are within normal limits. What is the likely diagnosis?

A

Conn Syndrome

28
Q

An Addison crisis is (Acute/Chronic)?

A

Acute

29
Q

An Addison disease is (Acute/Chronic)?

A

Chronic

30
Q

What is Addison’s crisis?

A

Sudden loss of adrenal cortical function

31
Q

Addison’s disease results in (Hyper/Hypo) tension?

A

Hypo

32
Q

What is the number one cause of an Addisonian crisis?

A

Abrupt withdrawal of corticosteroid therapy in patients with adrenal atrophy due to long term steroid administration.

33
Q

What is the number one cause of acute adrenal insufficiency?

A

Abrupt withdrawal of corticosteroid therapy in patients with adrenal atrophy due to long term steroid administration

34
Q

What is Waterhouse-Friderichsen syndrome?

A

Acute, bilateral, hemorrhagic infarction of the adrenal cortex secondary to meningococcus or pseudomonas septicemia

35
Q

What is Addison’s disease?

A

Fatal wasting disorder caused by failure of the adrenal glands to produce glucocorticoids, mineralcorticoids, and androgens.

36
Q

Patients with Addison’s disease will show what behavioural change?

A

Salty food preference

37
Q

Patient presents to your office complaining of unexplained weight loss. She thinks it is due to recent bouts of vomiting and diarrhea. The patients blood pressure is 85/50. Blood results show Hyperkalemia and hyponatremia. Palpation reveals tan pigmentations and areas of dark patches on the skin. Recently, the patient reports a craving for salty potato chips. What is the likely diagnosis?

A

Addison’s disease

38
Q

A patient with Addison’s disease will be (Hyper/Hypo) natremic?

A

Hypo

39
Q

A patient with Addison’s disease will be (Hyper/Hypo) kalemic?

A

Hyper

40
Q

How does Addison’s disease cause tan pigmentation on the skin?

A

Propiomelanocortin levels will increase resulting in an increase in Melanocytes stimulating hormone (MASH) causing hyperpigmentation and a permanent tan (bronzed complexion) in absence of sunlight

41
Q

A pheochromocytoma hypersecretes ____

A

Catecholamines

42
Q

How is a pheochromocytoma diagnosed?

A

Urine test

43
Q

A pheochromocytoma causes secondary (Hypotension/Hypertension)?

A

Hypertension

44
Q

Von Hippl Lindow syndrome presents with what tumor?

A

Pheochromocytoma

45
Q

42 year old female patient presents with chief complaints of headache and a diagnosis of generalized anxiety disorder from her PCP 3 months ago. Upon physical examination the patient presents with cold clammy hands and pale skin. Auscultation reveals a cardiac arrhythmia. Her blood pressure is 145/100. Urinalysis shows high levels of epinephrine and norepinephrine. What is the likely diagnosis?

A

Pheochromocytoma

46
Q

What is the pathogenesis of Type I Diabetes mellitus?

A

Genetic predisposition with environmental trigger leading to autoimmune destruction of insulin-secreting (B) cells

47
Q

Type I diabetes mellitus involves destruction of what cells of the pancreas?

A

B (beta) cells

48
Q

What environmental insults can cause type I diabetes mellitus?

A

Viral infection from EBV, cytomegalovirus, and adenovirus or other types of beta-cell damage

49
Q

Diabetes mellitus type 1 commonly occurs (Earlier/Later) in life?

A

Earlier

50
Q

What is the pathogenesis of type 2 diabetes mellitus?

A

Resistance of peripheral cells to the action of normal levels of insulin causes increased pancreatic secretion of insulin leading to eventual exhaustion of the B cells of the pancreas

51
Q

Diabetes mellitus type 2 tends to occur (Earlier/Later) in life?

A

Later

52
Q

What is the end result of diabetes mellitus type 1 or 2?

A

Hyperglycemia

53
Q

What are short term consequences of diabetes mellitus?

A

Hyperglycemia
Metabolic ketoacidosis leading to pungent, fruity odor in type I
Kussmaul’s respirations to increase ventilation in type I
Dehydration

54
Q

A coma is a short term consequence of diabetes mellitus (TRUE/FALSE)?

A

TRUE

55
Q

What is a hyperosmolar coma?

A

Coma in diabetics where they cannot maintain their blood pressure

56
Q

What is a hypoglycemic coma?

A

Loss of consciousness resulting from abnormally low blood sugar due to excess insulin or systemic infection

57
Q

Kussmaul’s respiration’s are a compensatory mechanism to _______________________ seen in type I diabetes mellitus?

A

Metabolic ketoacidosis

58
Q

What is a Kussmaul’s respiration?

A

Increased ventilation to cast off excess CO2 in ketoacidosis

59
Q

Glycosylation is an example of a long term consequence of diabetes mellitus (TRUE/FALSE)?

A

TRUE

60
Q

Long term consequences of diabetes mellitus are ____

A

Chronic diseases

61
Q

What is the pattern of diabetic neuropathy?

A

Glove-stocking

62
Q

Degeneration of the retina in a patient with diabetes mellitus is an example of a short term complication of diabetes mellitus (TRUE/FALSE)?

A

FALSE

63
Q

How does a corticotrope pituitary adenoma cause hirsutism in patients with Cushing’s?

A

ACTH will affect the zone reticularis of the adrenal cortex to increase androgen secretion with increases hair growth

64
Q

Why do patients with Cushing’s syndrome present with purple striae (stretch marks)?

A

Cortisol inhibits fibroblasts which weakens the dermis of the skin leading to mechanical separation and bleeding into areas of the dermis that have torn

NYCC Visceral Pathology (40 decks)

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