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visceral endocrine
visceral parathyroid and adrenal pathology
Question | Answer |
---|---|
This is due to surgical removal of the parathyroids at the time of thyroidectomy | hypoparathyroidism |
radioactive iodine therapy, familial, agenesis of parathyroid (diGeorge syndrome) | hypoparathyroidism |
lab findings for hypoparathyroidism? | decreased PTH, decreased serum calcium, increased phosphatemia |
patient presents with increased neuromuscular excitability, tingling in the hands and feet, perioral numbness, muscle cramps, tetany and laryngeal stridor | hypoparathyroidism |
CNS symptoms of hypoparathyroidism | convulsions, paranoia and psychoses |
Tests for hypoparathyroidism? | Trousseau's sign and Chvostek's sign |
End-organ insensitivity to PTS | psuedohypoparathyroidism |
lab tests for pseudohypoparathyroidism? | Normal PTH, decreased serum calcium, increased phosphatemia |
cAMP in response to PTH is impaired in this disease | pseudohypoparathyroidism |
Patient presents with short stature, obesity, mental retardation, subcutaneous calcification, short metacarpals and metatarsals | pseudohypoparathyroidism |
Normal levels of PTH, decreasd serum calcium, increased phosphatemia, normal cAMP | pseudopseudohypoparathyroidism |
The etiology for primary hyperparathyroidism is what? | parathyroidadenoma, MEN I |
The etiology for secondary hyperparathyroidism is what? | chronic renal failure (retention of phosphorus drives the calcium down and the PTH up) |
Lab tests for secondary hyperparathyroidism? | Increased PTH, hypophosphatemia, increased serum calcium |
increased bone resorption, decreased renal clearance of calcium and increased intestinal absorption of calcium are all contributing factors for what? | increased serum calcium associated with secondary hyperparathyroidism |
Bone, stone, abdominal groan, moan, and asystole are clinical findings for whatZ? | hyperparathyroidism |
prolonged exposure to elevated levels of either endogenous glucocorticoids or exogenous glucocorticoids leads to what? | cushing's syndrome |
cushing's syndrome is associated with an increase in what? | cortisol |
The etiology for this disease includes adenoma, bilateral adrenal hyperplasia, secondary to oat cell carcinoma or exogenous steroid administration | cushing's syndrome |
patient presents with moon face, facial plethora, thick web neck (buffalo hump), truncal obesity, thin extremities, muscle wasting, purple striae, hypertension | cushing's syndrome |
in females with this disease, patients present with hirsutism, acne, infertility, and menstrual disturbances | cushing's syndrome |
Conn's syndrome is aka what? | Primary Hyperaldosteronism |
the etiology for what disease is a aldosterone secreting neoplasm? | conn's syndrome |
patient presents with increased blood pressure, hypernatremia, hypokalemia, increased serum aldosterone, muscle cramps and weakness, and headache | conn's syndrome |
what is an acute adrenal insufficiency referred to as? | addisonian crisis |
abrupt withdrawal of steroids from patients with chronic steroid administration will develop what? | acute adrenal insufficiency; addisonian crisis |
an etiology for what is acute hemorrhagic destruction of both adrenals by trauma? | adrenal insufficiency; addisonian crisis |
patient presents with severe abdominal pain, nausea and vomiting, fever, hypotension, confusion and hypoglycemia | adrenal insufficiency |
a chronic adrenal insufficiency is referred to as what? | addison's disease |
what is the etiology for addison's disease? | autoimmune |
decreased aldosterone and cortisol levels are indicative of what disease? | addison's disease; chronic adrenal insufficiency |
patient presents with hypotension, hypoglycemia, skin pigmentation, hyperkalemia, cardiac arrhythmias | addison's disease |
lab findings for addison's disease? | decreased aldosterone, decreased glucocorticoid, increased ACTH |
a defect in one of the enzymes that are necessary for the synthesis of cortisol (21, 17 or 11 hydroxylase)will cause what? | Congenital adrenal hyperplasia |
lab tests for congenital adrenal hyperplasia? | decreased cortisol, decreased OR increased aldosterone, increased ACTH |
Female infants with ambiguous genitalia most likely have what disease? | congenital adrenal hyperplasia |
female patients present with amenorrhea and virilization, males present with precocious puberty | congenital adrenal hyperplasia |
what diseases are the result of a lost adrenal medulla? | none |
a tumor of the adrenal medulla casues what? | pheochromocytoma: increased catecholamines |
patient presents with increased heart rate, increased tachypnea, nervousness and anxiousness | tumor of the adrenal medulla |
This is caused by hyperglycemia and inadequate action of insulin on body tissues | diabetes mellitus |
decreased circulating levels of insulin or resistance of target tissues to the actions of insulin causes? | diabetes mellitus |
random plasma glucose >200mg/dL,fasting plasma glucose >136 mg/dL | diabetes mellitus |
what type of diabetes mellitus is autoimmune where AB attack beta cells resulting in a decrease or absence of insulin production? | DM Type I |
what type of diabetes mellitus is genetic, with no antibody and simply the result of insulin resistance? | DM Type II |
patient presents with increased urine (polyuria), increased thirst (polydypsia), weight loss, infection of the skin, vulva and urinary tract, and blurring of vision? | diabetes mellitus |
what are some acute complications of diabetes mellitus? | ketoacidosis, hyperosmolar non-ketotic coma, hypoglycemic coma |
what are some chronic complications of diabetes mellitus? | microvascular disorders in the eye, kidney failure, autonomic neuropathy |
patient presents with gycosuria (loss of sugar in the urine), hyperglycemia, ketonemia, ketonuria, kussmaul's respiration, odor of acetone on the breath, and marked dehydration | ketoacidosis |
This is commonly found in elderly patients, precipitated with infection, altered consciousness | hyperosmolar non-ketotic coma |
Hypoglycemic coma is aka what? | insulin shock |
decreased serum glucose due to either increased insulin dosage or delay in ingestion of a meal or increased physical activity or adrenergic stimulation | hypoglycemic coma |