020215 pearls

Question 1

cancer-usually talking about hypercalcemia or hypocalcemia?

Answer 1

hyper

Question 2

biochemical hallmark of primary hyperaldosteronism

Answer 2

increased aldosterone to renin ratio

Question 3

how do meds impact testing for suspected primary hyperaldosteronism?

Answer 3

meds can have effect on aldosterone and renin levels and interfere with testing

can’t use ratio test of aldosterone to renin if pt is on such meds

Question 4

why do paragangliomas secrete only NE?

Answer 4

because PNMT (which converts NE to E) is induced by high cortisol levels and extra-adrenal levels of cortisol aren’t high enough to induce PNMT

Question 5

most common cause of PTH-independent hypercalcemia

Answer 5

cancer

granulomatous diseases

Question 6

how to categorize hypocalcemic pts

Answer 6

elevated PTH or low/low normal PTH (hypoparathyroidism)

Question 7

secondary hyperparathyroidism is most commonly caused by

Answer 7

kidney failure
vit D deficiency
bowel disease

Question 8

PTH resistance looks similar to

Answer 8

secondary hyperparathyroidism, but PTH resistance is much less common