PATH 179 LO 6 Flashcards
What are the signs and symptoms of hyperaldrenalism/cushings?
-excess secretion of hormone monilizes lipids and ^ level in blood = obesity confined to trunk, round moon - shaped face and fat pad behind shoulders (buffalo hump)
What causes hyperaldrenalism/cushings?
excess production of glucocorticoid hormone from
- Functioning adrenal or non-adrenal tumor
- bilateral hyperplasia of adrenal cortex
- External administration of cortisone
What is the rad appearance for hyperaldrenalism/cushings?
CT -general enlargement of adrenal glands -benign or malignant tumor -Cranial CT can also find associated intrasellar lesion x-ray: diffuse osteoporosis -Leads to spontanoes fractures -Aseptic necrosis of the femur and humerus -Widening of the mediastinum -Renal calculi or nephrocalinosis
what is aldsteronism?
overproduction of alsosterone
Causes retention of Na and water and loss of K in urine
What is the signs and symptoms of aldosteronism?
-hypertension, muscular weakness or paralysis, excessive thrist
what is the rad appearance of aldosteronism?
CT/MRI determine location of tumor
What are the signs and symptoms of adrenogenital syndrome?
- excessive secretion of andogenically active substances
- results in accelerated skeleta; maturation, premature epiphyseal fusion may = dwarfism
- women= masculinization, hair on face, breasts diminsh, ovulation and menstration cease
What is hypoadrenalism?
-adrenal insufficiency
What causes hypoaldrenalism?
- mostly from excess steroid administration
- Addisons Dz-primary adrenocortical insufficiency from progressive cortical destruction
What are the signs and symptoms of acute hypoadrenalism?
- hypotension
- Rapid pulse
- Vomiting
- Diarrhea
What are the symptoms of chronic hypoaderenalism?
- easily fatigued
- anorexia
- Weakness
- Weight loss
- Increased melanin pigmentation
What is the rad exam for hypoadrenalism?
- CT: enlargement of gland
- Small heart
What is adrenal carcinoma?
-functioning tumors that cause Cushing syndrome, virilization, feminization or aldosteronism
What is the rad appearance for adrenal carcinoma?
CT: large mass- irregular mass containing low-density areas with calcification. Contrast enhancing peripherpy. Mets may also detected
what is adrenal mets?
metastases to the adrenal gland
What causes adrenal mets?
- carcinomas of the lung, breast, kidney, ovary, melanomas and GI tract
- Causes downward displacement of the kidney with flattening of the upper pole
What is the rad apearance of adrenal mets?
-CT: solid, soft tissue mass that vary in size and number
What is the disease of adrenal medulla?
Pheochromocytoma
What is pheochromocytoma?
- tumor that arises in the adrenal medulla
- Produces excesive epinephrine and noreipinephrine
What is the rad exam for pheochromocytoma?
CT/US/MRI-localization of tumor, mets
What is the rad appearance of pheochromocytoma?
- round, oval or pear shaped masses, greater than 3 cm
- Arise in abdomen, rarely in chest or neck
What are the signs and symptoms of hyperpituitarism (acromegaly)?
-Acromegaly: continued growth of hands, feet, face
-Proliferation of cartilage causes joint space widening (especially MCP, hip)
-Longe fingers, bony tifts of distal phalanges, spade-shpae hand
-Degenerative changes develop early with spurring
-
What is the rad appearance for hyperpituiitarism?
- thickening of the heel pads (tissue inferior to calcanues)
- bones of skull thick with increased density, especially at frontal and occipital regions (frontal/occipital bulge)
- Sinuses enlarge
- Prognathism (jutting jaw)
- Lat skull: expansion erosion of sella turcica from piuitary growth
What are the signs and symptoms of hypopituitarism?
- dwarfism:
- in kids, decreased HGH causes delayed appearance of growth centers > bones fail to grow normally in length and width, small
- Normal proportion, normal intellect
- May appear to have hydrocephaly b/c growth stops at a time when the skull is naturally bigger than face, and remains that way into adulthood
What is the rad appearance of hypopituitarism?
- adults: heart and kidneys small
- Calcification may develop in the articular cartilages
what is the rad exams for hypopituitarism?
MRI modality used b/c can directly image sellar regions
What is the rad exam of DI?
MRI-absence of signal in post pit
What is the rad appearance of DI?
masive dilation of the rena pelvis, calyces and ureters
What are the signs and symptoms of hyperthyroidism?
- graves disease (3rd and 4th decades, females)
- Nervousness, insomina, tremors, excessive sweating, heat intolerance, tachycardia, palpitations, weight loss despite increased appetite
- Exophthalmos (outward protrustion of eye from edema behind)
What is the rad appearance of hyperthyroidism?
- CT: in severe disease pt may develop cardiac failure, cardiomegaly, pulmonary congestion visible on CT
- May also detect thickening of extraocular muscles (eyes)
define cretinism
is hypothyroidism from birth
what are the signs and symptoms of hypothyroidism
cretism:
- short stature
- coarse features, protrusion tongue, broad flat nose, widely set eyes, sparse hair
- Protuberant abdomen with umbilical hernia
What is the rad appearance for hypothyroidism?
kids
-delay of ossification and retarded bone age
-Skull changes common: thick or cranial vault, underaeration of sinuses and mastoids, widened sutures, delay in teeth eruption
-Bone age hand and wrist
-Skull series
In adults
-Cardiomegaly due to pericardial effusion
-Soft tissue thickening in extremity films
What is the treatment for hypothyroidism?
- if tumor is caus: surgery, CT,RT
- If functional cause: TH replacement therapy (thyroxine)
What is goiter?
enlargement of thyroid gland not as result of inflammatory or neoplasia, not intially asociated with hyperthyroidism or myxedma
What are the signs and symptoms of goiter?
- may be some lethargy
- Sift tissue enlargement around anterior neck from thyroid
What is the rad appearance for goiter?
- radioactive nuclear med scan best
- Soft-tissue enlargement may be seen on lat soft tissue neck x-ray
- US can detect if thyroid is cystic
- CT/MR only if US shows nothing
What is the treatment for goiter?
- oral thyroxine controls size
- If goiter cont to grow, surgery may be done to prevent impingement on adajcent structures
What is benign thyroid carcinomas?
- encapsulated tumors
- Located within the neck
- Deviation or compressed of the trachea or superior portion of the anterior mediastinum
- May calcify
What is hyperparathroidisn?
excessive secretion of parathhormone > elevated levels of calcium and phosphate
What is the primary cause of hyperparathyroidism?
discrete adenoma, carcinoma or generalized hyperplasia or nonparathyroid tumor
What is the secondary cause of hyperparathyroidism?
chronic renal failure
What is the teritary cause of hyperparathyroidism?
development of auntonomous function parathyroid glands in pt who have bone disease in chronic renal failure
What are the signs and symptoms of hyperparathyroidism?
- pathological bone fractures
- Kyphosis
What is the treatment for paratyroidism?
calcium replacement therapy
What causes hypoparathyroidism?
injury or accidental removal of glands during thyroidectomy
What are the signs and symptoms of hypoparathyroidism?
- sustained muscle contraction (tetany)
- Muscle cramps in hands and feet, numbness and tingling
- Spasm of laryngea muscles can cause fatal respiratory obstruction
What is the rad appearance for hypoparathyroidism?
CT: cerebral calcification, increased density in long bones
What is the treatment for hypoparathyroidism?
synthethic PTH relieves symptom
