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NYCC Visceral Pathology > Parathyroid & Adrenal Gland Pathology > Flashcards

Parathyroid & Adrenal Gland Pathology Flashcards

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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
A patient with Conn syndrome will have (Hyper/Hypo) tension?
Hyper
26
A patient with Conn syndrome will have (Hyper/Hypo) kalemia?
Hypo
27
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?
Conn Syndrome
28
An Addison crisis is (Acute/Chronic)?
Acute
29
An Addison disease is (Acute/Chronic)?
Chronic
30
What is Addison's crisis?
Sudden loss of adrenal cortical function
31
Addison's disease results in (Hyper/Hypo) tension?
Hypo
32
What is the number one cause of an Addisonian crisis?
Abrupt withdrawal of corticosteroid therapy in patients with adrenal atrophy due to long term steroid administration.
33
What is the number one cause of acute adrenal insufficiency?
Abrupt withdrawal of corticosteroid therapy in patients with adrenal atrophy due to long term steroid administration
34
What is Waterhouse-Friderichsen syndrome?
Acute, bilateral, hemorrhagic infarction of the adrenal cortex secondary to meningococcus or pseudomonas septicemia
35
What is Addison's disease?
Fatal wasting disorder caused by failure of the adrenal glands to produce glucocorticoids, mineralcorticoids, and androgens.
36
Patients with Addison's disease will show what behavioural change?
Salty food preference
37
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?
Addison's disease
38
A patient with Addison's disease will be (Hyper/Hypo) natremic?
Hypo
39
A patient with Addison's disease will be (Hyper/Hypo) kalemic?
Hyper
40
How does Addison's disease cause tan pigmentation on the skin?
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
A pheochromocytoma hypersecretes ____
Catecholamines
42
How is a pheochromocytoma diagnosed?
Urine test
43
A pheochromocytoma causes secondary (Hypotension/Hypertension)?
Hypertension
44
Von Hippl Lindow syndrome presents with what tumor?
Pheochromocytoma
45
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?
Pheochromocytoma
46
What is the pathogenesis of Type I Diabetes mellitus?
Genetic predisposition with environmental trigger leading to autoimmune destruction of insulin-secreting (B) cells
47
Type I diabetes mellitus involves destruction of what cells of the pancreas?
B (beta) cells
48
What environmental insults can cause type I diabetes mellitus?
Viral infection from EBV, cytomegalovirus, and adenovirus or other types of beta-cell damage
49
Diabetes mellitus type 1 commonly occurs (Earlier/Later) in life?
Earlier
50
What is the pathogenesis of type 2 diabetes mellitus?
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
Diabetes mellitus type 2 tends to occur (Earlier/Later) in life?
Later
52
What is the end result of diabetes mellitus type 1 or 2?
Hyperglycemia
53
What are short term consequences of diabetes mellitus?
Hyperglycemia Metabolic ketoacidosis leading to pungent, fruity odor in type I Kussmaul's respirations to increase ventilation in type I Dehydration
54
A coma is a short term consequence of diabetes mellitus (TRUE/FALSE)?
TRUE
55
What is a hyperosmolar coma?
Coma in diabetics where they cannot maintain their blood pressure
56
What is a hypoglycemic coma?
Loss of consciousness resulting from abnormally low blood sugar due to excess insulin or systemic infection
57
Kussmaul's respiration's are a compensatory mechanism to _______________________ seen in type I diabetes mellitus?
Metabolic ketoacidosis
58
What is a Kussmaul's respiration?
Increased ventilation to cast off excess CO2 in ketoacidosis
59
Glycosylation is an example of a long term consequence of diabetes mellitus (TRUE/FALSE)?
TRUE
60
Long term consequences of diabetes mellitus are ____
Chronic diseases
61
What is the pattern of diabetic neuropathy?
Glove-stocking
62
Degeneration of the retina in a patient with diabetes mellitus is an example of a short term complication of diabetes mellitus (TRUE/FALSE)?
FALSE
63
How does a corticotrope pituitary adenoma cause hirsutism in patients with Cushing's?
ACTH will affect the zone reticularis of the adrenal cortex to increase androgen secretion with increases hair growth
64
Why do patients with Cushing's syndrome present with purple striae (stretch marks)?
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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