Pathophysiology for Endocrine Flashcards

1
Q

What would lab results show in primary hyperparathyroidism?

A

high PTH
high serum Ca2+
low serum Pi
high vitamin D (active form)

hypercalcemia & hypophosphatemia (due to tumor on parathyroid gland so keeps producing PTH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What would lab results show in 21B hydroxylase deficiency?

A

low cortisol
low mineralcorticoids
high androgens
high ACTH

extreme sexual characteristics, hyperkalemia & hypoglycemia

**most common enzyme deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What would lab results show in 11B hydroxylase deficiency?

A
high mineralcorticoids (DOC)
low cortisol
low aldosterone
high androgens
high ACTH

**still have mineralcorticoids that increase Na+ reabsorb & increase K+ & H+ secretion (hypokalemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What would lab results show in 17alpha hydroxylase deficiency?

A

low androgens
low cortisol
high aldosterone
high ACTH

excess mineralcorticoids can cause increase in BP & hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What would lab results show in primary hypercortisolism?

A

high cortisol
low ACTH
low CRH

due to overproduction of cortisol by adrenal gland (ACHT independent) so still get negative feedback of cortisol on pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What would lab results show in secondary hypercortisolism?

A

high cortisol
high ACTH
low CRH

hyperpigmentation due to increased ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What would lab results show in primary cortisol deficiency?

A

adrenal gland insufficiency:

low cortisol
low aldosterone
high CRH
high ACTH
hyperpigmentation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What would lab results show with steroid administration (exogenous glucocorticoids)?

A

low CRH
low ACTH
low cortisol

**w/ symptoms of excess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What would lab results show in secondary cortisol deficiency?

A

low cortisol
low ACTH
high CRH
normal aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the cause of Cushing’s disease? What would the lab results show?

A

pituitary tumor

high cortisol
high ACTH
low CRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the cause of Addison’s disease?

A

primary adrenal insufficiency

autoimmune destruction of all zones of adrenal cortex (decreased synthesis of all hormones from cortex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What would lab results show in primary hyperaldosteronism?

A

high aldosterone
low plasma renin

hypertension, hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is another name for primary hyperaldosteronism?

A

Conn’s syndrome (excessive release of aldosterone from adrenal cortex…issue @ zona glomerulosa)

CoNNNNNN (extra Na+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would lab results show in secondary hyperaldosteronism?

A

high aldosterone
high plasma renin

hypertension, hypokalemia (due to excessive renin secretion by juxtaglomerular cells in kidney)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What would lab results show in hypoaldosteronism?

A

low aldosterone
low plasma Na+
hypotension

*if affects glucocorticoid synthesis, will lead to decrease in cortisol production & cause increase in ACTH (hyperpigmentation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What would lab results show if pt has pheochromocytoma?

A

adrenal medulla tumor that causes increase in production of catecholamines

high epi
high norepi

headaches, palpitations, sweating, hypertension

17
Q

What can block synthesis of thyroid hormone & at which part of the process?

A

Perchlorate & Thiocynate: NIS (Na+ & I- co transport)

PTU: blocks all steps catalyzed by peroxidase (1st blocks organification of I)

Diodinase: mimics dietary I- deficiency b/c blocks recycling of MIT & DIT

mutation in PDS gene: affects Pendrin channel would block transport of I2 into lumen of follicle

18
Q

What is Wolff-Chaikoff syndrome?

A

effect of high I- levels that inhibits organification & synthesis of thyroid hormones

19
Q

What would lab results show with high TBG?

When would you see high TBG?

A

increased T4
decreased T3 resin uptake

occurs in pregnancy

20
Q

What would lab results show with low TBG?

When would you see low TBG?

A

decreased T4
increased T3 resin uptake

hepatic failure

21
Q

What would lab results show in Grave’s disease?

A

high serum T4/T3
low TSH
circulating thyroid-stimulating immunoglobs*

goiter & exopthalmos

pregnancy

22
Q

What would lab results show in Hashimoto’s?

A

low serum T4/T3
high TSH
circulating TRG or TPO antibodies (impairs thyroid hormone synthesis)

goiter

23
Q

What would lab results show in I- deficiency?

A

low serum T4/T3
high TSH

goiter

24
Q

What would lab results show in Sheehan syndrome?

A

symptoms of hypothyroidism (disease of pituitary gland that blocks TSH secretion): low T4/T3 and low TSH

NO goiter b/c no TSH (pt also presents w/ issue in lactation, amenorrhea, etc)

25
Q

What would lab results show in primary hyperparathyroidism?

A

high PTH
high serum Ca2+
low serum Pi
high vitamin D

adenoma on parathyroid gland causes unregulated secretion of PTH

hypercalcemia, hypophosphatemia

26
Q

What would lab results show in secondary hyperparathryoidism? (if due to renal failure)

A

high PTH
low Ca2+
high Pi
low vitamin D

27
Q

What would lab results show in secondary hyperparathyroidism? (if due to vit D deficiency)

A

high PTH
low serum Ca2+
low serum Pi
low vitamin D

28
Q

What would lab results show in hypoparathyroidism?

A

low PTH
low serum Ca2+
high serum Pi
low vitamin D

hypocalcemia & hyperphosphatemia

29
Q

What would lab results show in vitamin D deficiency?

A
high PTH
low Ca2+
low Pi (serum)
high Pi & cAMP (in urine)
low active & precursor vit D in serum
30
Q

What would lab results show in pseudo-hypoparathyroidism type 1a

A

high PTH
low Ca2+
high Pi
low vitamin D

PTH resistance (PTH cannot work @ its receptor to induce translation of its message via AC in bone & kidney cells)

31
Q

What would lab results show in humoral hypercalcemia of malignancy?

A

low PTH
high Ca2+
low Pi
low vitamin D

tumor makes PTHrP that mimics PTH so leads to increase in Ca2+ that negatively feeds back onto endogenous PTH levels

32
Q

What would lab results show in hypocalciuric hypercalcemia?

A

normal PTH
high serum Ca2+
low urine Ca2+
normal Pi & vitamin D

CaSR on PTH gland & in kidney can’t sense changes in Ca2+ so thinks that Ca2+ is low

33
Q

What can cause issues in vitamin D metabolism?

A

dietary deficiency of vitamin D

deficit in synthesis of active vitamin D (no 1 alpha hydroxylase)

vitamin D resistance (@ its receptor)

34
Q

What would lab results show in rickets?

A

low Ca2+ & low Pi

depends if @ 1 alpha hydroxylase or vitamin D receptor

35
Q

What would lab results show in osteomalacia?

A

low Ca2+ & low Pi

bone pain/muscle weakness
bone tenderness
fracture
muscle spasms

36
Q

What would lab results show for a pt with an ectopic-ACTH secreting tumor?

A

high cortisol
low ACTH (coming from pit)
low CRH

NO hyperpigmentation