Hormonal Diseases

Question 1

Hyperparathyroidism is the result of overactivity of which gland?

Answer 1

Parathyroid

Question 2

Is PTH a strong osteoblastic or osteoclastic hormone?

Answer 2

Osteoclastic

Question 3

What is the most common cause of hypercalcemia?

Answer 3

Primary hyperparathyroidism caused by parathyroid adenoma (90%)

Question 4

Hypercalcemia due to high PTH levels leads to a deficiency of what mineral?

Answer 4

Phosphate

Question 5

What is the cause of secondary HPT?

Answer 5

Complication of chronic renal disease

Question 6

Tertiary HPT is seen in what population?

Answer 6

Dialysis patients

Question 7

What is tertiary HPT?

Answer 7

When the parathyroid gland acts independently from serum calcium levels

Question 8

HPT is more common in what gender and what age range?

Answer 8

Females aged 30-50

Question 9

What are the symptoms of HPT?

Answer 9

Bone pain, fractures, lethargy, polyuria

Question 10

What are the symptoms of hypercalcemia seen with HPT?

Answer 10

Muscle weakness and hypertonia

Question 11

What elevated lab levels are seen with PTH?

Answer 11

Alkaline phosphatase and PTH

Question 12

What GI complications can be seen with HPT?

Answer 12

Rengal stones, pancreatitis

Question 13

What is the diagnostic and hallmark feature of HPT seen on X-ray?

Answer 13

Subperiosteal resorption

Question 14

What is the term for the cystic accumulations of fibrous tissue commonly seen with HPT?

Answer 14

Brown tumor

Question 15

What is the most common location for subperiosteal resorption that is seen with HPT?

Answer 15

RADIAL margins of the middle and proximal phalanges of the 2nd and 3rd digits

Question 16

What unique dental feature is seen with HPT?

Answer 16

Loss of the lamina dura of the teeth

Question 17

What kind of resorption is seen at the distal phalanges of the fingers with HPT?

Answer 17

Ungal tuft resorption

Question 18

The SI involvement with HPT can resemble what other condition but what also sets it apart?

Answer 18

AS (if HPT, renal stones or kidney issues are likely present)

Question 19

What radiographic features are more sensitive to hyperparathyroidism?

Answer 19

Rugger jersey spine, subperiosteal resorption at SI joints, salt-and-pepper skull

Question 20

What is unique about the radiographic features of HPT following treatment?

Answer 20

Radiographic features disappear

Question 21

What causes the rugged jersey spine appearance in HPT?

Answer 21

Calcium deposits in vertebral endplates leading to sclerosis

Question 22

If bilateral symmetric SI joint widening and resorption is present, what 3 conditions could be assumed?

Answer 22

AS, enteropathic arthropathy, HPT (rule out with history)

Question 23

What is another name for a Brown tumor?

Answer 23

Osteoclastoma

Question 24

What causes the “brown” appearance of an osteoclastoma?

Answer 24

Hemosiderin from the focal hemorrhage

Question 25

What is the most common location for a brown tumor?

Answer 25

Can centrally happen anywhere (geographic)

Question 26

What hormones are released from the anterior pituitary? Posterior?

Answer 26

``` Anterior = GH, ACTH, TSH, FSH/LH, Prolactin Posterior = ADH, oxytocin ```

Question 27

What type of tumor accounts for 10% of all neoplasms of the cranium?

Answer 27

Pituitary

Question 28

Autopsies have revealed that what percentage of the population actually have small pituitary adenomas?

Answer 28

25%!

Question 29

What are the general symptoms of a pituitary adenoma?

Answer 29

HEADACHES, visual disturbances, generalized discomfort in extremities

Question 30

What are the normal dimensions of the sella turcica?

Answer 30

12 mm depth, 16 mm sagittal plane

Question 31

How would we know if an enlarged sella turcica is only a normal variant in that patient?

Answer 31

No present symptoms

Question 32

Acromegaly and gigantism predispose an individual to what condition that larges impacts their skeletal system?

Answer 32

DJD (also a reduced lifespan)

Question 33

Acromegaly and gigantism primarily affect which body parts?

Answer 33

Hands and feet (acral parts)

Question 34

What causes acromegaly?

Answer 34

Over-secretion of growth hormone from a pituitary adenoma

Question 35

What does acromegaly mean?

Answer 35

"Large extremities"

Question 36

A pragmatic jaw is indicative of what condition?

Answer 36

Acromegaly

Question 37

What is the key difference between acromegaly and gigantism?

Answer 37

Acromegaly is not accompanied by an increase in height

Question 38

What are the radiographic features associated with acromegaly?

Answer 38

"Spade-like" distal tufts (phalanges), hooking osteophytes, increased tissue thickness

Question 39

The hooked osteophytes seen in acromegaly can be compared to what other condition?

Answer 39

Hemochromatosis (look at history)

Question 40

What radiographic feature of acromegaly can be seen on the skull X-ray?

Answer 40

Prominent frontal sinus and forehead

Question 41

What unique radiographic sign of acromegaly can be seen in the feet?

Answer 41

Increased heal pad thickness (normal is 8-12mm)

Question 42

What is the term for an enlarged tongue, commonly seen in acromegaly?

Answer 42

Macroglossia

Question 43

Which involves an over-secretin of growth hormone PRIOR to skeletal maturity: acromegaly or gigantism?

Answer 43

Gigantism (open physis)

Question 44

What is another name for Cushing's disease?

Answer 44

Hypercortisolism

Question 45

What causes Cushing's?

Answer 45

Increased production of cortisol or excessive use of cortisol or other steroid hormones

Question 46

What is the most common cause of hypercortisolism?

Answer 46

EXOgenous corticosteroid administration in patients requiring immunosuppression

Question 47

What is the most common cause of Cushing's?

Answer 47

ENDOgenous over-secretion by ACTH, adrenal cortex, or tumor

Question 48

What are common visual signs seen in patients with Cushing's?

Answer 48

"Moon face", "buffalo hump", accelerated hair growth, purple straie on abdomen, weight gain

Question 49

What serious bone complication can be seen in those with Cushing's due to prolonged corticosteroid use?

Answer 49

AVN