Endocrine Disorders Flashcards
(52 cards)
What condition is characterized by the excess secretion of PTH from one or more parathyroid glands?
Primary hyperparathyroidism
What is the most common cause of primary hyperparathyroidism?
Parathyroid adenoma
What gene mutation is implicated in some cases of parathyroid adenomas?
CASR gene
In cases of primary hyperparathyroidism, PTH will remain elevated despite increasing ____ levels
Ca2+
How does hyperparathyroidism affect bone?
- increased osteoclastic activity
- decreased osteoblastic activity
How does hyperparathyroidism affect the kidneys?
- increased reabsorption of Ca
- increased excretion of phosphate
- increased calcitriol production
What are some of the generalized signs and symptoms of Hypocalcemia?
- hyperactive reflexes
- spontaneous m. contractions
- convulsions
- laryngeal spasm w/ airway obstruction
- severe m. cramps
- mild tingling in hands and feet
- depression, paranoia, psychosis
What physiological events occur in Dissecting osteitis?
- Osteoclasts are stimulated by the increased PTH levels
- Cutting cones into subperiosteal and endosteal surfaces of cortical bone
- Collagen is laid down adjacent to trabeculae
What physiological events occur in Osteitis fibrosa?
- Accelerated bone remodeling
- Trabeculae is resorbed
- Bone marrow replaced by fibrous tissue, macrophages, areas of hemorrhage from microfractures, and reactive bone formation
What physiological events occur in Osteitis fibrosa cystica?
- Brown tumors (geographic lytic lesion) develop which contain osteoclastic giant cells
- Visible bone changes on radiographic images
What are some of the radiographic characteristics of Primary Hyperparathyroidism?
- Fractures
- Osteolysis
- “Lace-like” appearance of bone
- Loss of cortical line definition
- Appearance of brown tumors
- Soft tissue calcifications (metastatic)
- subperiosteal resorption
- subchondral resorption (later sign)
What is the most common location of subperiosteal resorption?
radial aspect, middle phalanx, of 2nd & 3rd digits
What are some of the clinical manifestations of a patient with primary hyperparathyroidism?
- Hypercalcemia (persistence leads to impaired renal function, eventual failure) -> Kidney stones
- Peptic ulcers (GI problems)
- MSK pain (wave-like back pain)
- Fracture
(Stones, groans, moans, bones)
What is the best treatment options for Primary Hyperparathyroidism?
Surgical removal of the parathyroid gland adenoma
What condition is characterized by an increase in PTH secretion due to chronic renal failure?
Secondary Hyperparathyroidism
What condition is characterized by a parathyroid hyperplasia and hypercalcemia from long-standing secondary hyperparathyroidism?
Tertiary Hyperparathyroidism
What refers to the bone changes seen in patients with secondary/tertiary hyperparathyroidism due to end-stage kidney disease?
Renal Osteodystrophy
What radiographic finding is associated with renal osteodystrophy in the spine?
Rugger-jersey spine
How does hyperparathyroidism affect the intestines?
increased calbindin –> decreases vit D
Hyperphosphatemia can lead to what conditions in soft tissues?
Metastatic calcifications
What condition is commonly seen in dialysis patients that result in the bones to become more brittle and prone to fracture?
Adynamic variant of renal osteodystrophy (ARO)
What are some of the treatment options for Secondary Hyperparaythyroidism?
- Treatment for renal failure
- Vitamin D supplementation
- Drug therapy to control phosphate levels
What condition is characterized by the decreased PTH secretion?
Hypoparathyroidism
What is the most common cause of Hypoparathyroidism?
Idiopathic parathyroid atrophy
