Loading....
Coupon Accepted Successfully!

Medicine

Open Flashcards

Endocrine

Question
15 out of 16
 

Brown tumor seen in (AIIMS May 2014)



A Hypothyroidism
B Hyperthyroidism

C Hypoparathyroidism
D Hyperparathyroidism

Ans. D

Hyperparathyroidism

Pathology of Skeletal changes in hyperparathyroidism

1). Diffuse bone resorption: The Howship lacunae are filled with large number of osteoclasts and the Haversian canals are enlarged.

2). Brown tumours: The "tumour" is a well circumscribed dark brown area of soft consistency, situated where bone resorption has been severe.

3). Osteitis fibrosa cystica: Healing in case of hyperparathyroidism occurs by fibrous tissue replacement or sometimes the centre may liquefy and a bone cyst remains.

4). Deformities: Intervertebral disk becomes ballooned as they indent soft vertebral bodies forming the 'Cod Fish spine'.

Note: Osteopetrosis is not a feature.

X-Ray findings

1). Osteoporosis:

The early finding is that of generalized deossification.

2). Subperiosteal resorption:

Subperiosteal erosions are most frequently identified along the middle phalanges of the index and middle fingers is a characteristic feature. (Tufting of the phalanges.)

This x-ray feature is virtually diagnostic of hyperparathyroidism.

3). Pinhead stippling:

The skull displays a diffuse osteoporosis described as pinhead stippling (pepper pot appearance)

4). Mandible x-ray = Demineralization of mandible

5). Calciphylaxis = Metastatic calcification of blood vessel (secondary to hyperphosphatemia) may lead to ischemia damage to skin & other organs.

6). Rugger Jersey spine is seen in CRF

Location of the parathyroid adenoma:

a. After one hour of administration of technetium 99m, uptake is done by both thyroid and parathyroid gland.

b. After 3 hrs uptake evidence is there only in parathyroid. So by computer subtraction adenoma is located.

Endocrine Flashcard List

16 flashcards
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)
15)
16)