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Path Block 2 > 21-parathyroid Gland > Flashcards

21-parathyroid Gland Flashcards

0
Q

If parathyroid has very little fat, what does it mean

A

It is active

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1
Q

What cells are in parathyroid and what do they make

A

Chief cells -PTH

Oxyphil cells

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2
Q

What controls the PTH

A

Free levels of ionized calcium in blood stream

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3
Q

How do osteoblasts active osteoclasts

A

IL-1

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4
Q

What is calcium bound to

A

Albumin
Phosphate
Citrate

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5
Q

What gives the negative feedback for PTH

A

Free ionized calcium

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6
Q

What is hypoalbuminemia

A

Decrease total serum calcium but Norma ionized calcium

So normal PTH

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7
Q

When is tetany seen

A

Only when free ionized levels of calcium are low

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8
Q

What does an alkalosis state do to your calcium levels

A

PTH is high
Bound calcium is increased
Free calcium decreased

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9
Q

What are the causes for primary hyperparathyroidsism

A

Parathyroid adenoma -mc
Parathyroid hyperplasia 2mc
Parathyroid cancer

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10
Q

How does primary Hyperparathyrodism occurs

A

Sporadic or men1 or men 2a

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11
Q

How to primary parathyroid labs look like

A

Increased PTH
Increased Ca
Decreased phosphorus

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12
Q

Parathyroid adenoma anatomy

A

Solitary tumor and other three atrophy

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13
Q

Parathyroid hyperplasia anatomy

A

Whole thyroid involved

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14
Q

Parathyroid carcinoma anatomy

A

Same as adenoma with involvement of one gland and nodular

Only sign is metastasis

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15
Q

Mcc of Hypercalcemia in population

A

Unregulated over production of ptH by gland

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16
Q

What is the gland mostly involved in parathyroid adenoma

A

Right lower parathyroid gland

17
Q

How does the tc99 parathyroid scan show in parathyroid adenoma

A

There is uptake

18
Q

What glands are involved in parathyroid hyperplasia

A

All four so very little fat present

19
Q

Symptoms of primary hyperparathyroidism

A

Bone pain
Renal stones
Abdominal groans
Physics moans

Metastatic calcification a to several areas

20
Q

What does primary hyperparathyroidism lead to in the bone

A

Brown tumors - bulbous swellings

21
Q

What are brown tumors made of

A

Osteoclasts and fibroblast form tumor like lesions resembling giant cell tumors of bone - have hermosoderin

22
Q

What does primary hyperparathyroidism do to the kidney

A

Calcium oxalate renal stones - nephrolothiasis -mc

Nephrocalcinosis - calcification of renal tubules -no ADH -nephrogenic DI

23
Q

What is Nephrocalcinosis - and what does it lead to

A

In 1 para-hyper calcification of renal tubules -no ADH -nephrogenic DI

24
Q

Most common complain in 1 hyperparathyroidism and why

A

Constipation because gastrin decreases GI motility

25
Q

Mc presentation in 1hyperparathyrodism

A

Nephrolothiasis

26
Q

Osteitis fibrosa cystica ?

A

1hyper parathyroidism cystic and hemorrhagic bone lesions

Found in jaw and fingers

Eventually rupture blood vessels - leads to brown tumor

27
Q

1hyper PTH bone X-ray

A

Subperosteal bone resorption

Salt and pepper appearance

28
Q

Cns effects of primary hyper parathyroidism

A

Depression and seizures

29
Q

Cvs effects of primary hyper parathyroidism

A

Short qt interval

Diastolic hypertension

30
Q

Eye effects of primary hyper parathyroidism

A

Band keratopathy in the limbus of eyes due to metastatic calcification a

31
Q

What does Ca high low PTH mean

And what causes it

A

Secondary Hypercalcemia

Malignancy -scc, rcc
Sarcoidosis-vit d hyper
Thiazides
Hupervotaminosis

32
Q

What does multiple myeloma secrete from plasma cells to cause secondary Hypercalcemia

A

Il-1

33
Q

Sarcoidosis cause secondary Hypercalcemia by

A

macrophages in Granuloma secreting 1-alpha hydroxylase leading to hypervotaminosis D
-absorb too much calcium so PTH down

34
Q

What does vitamin d do

A

Increase Jejunum calcium absorption

35
Q

Lab for secondary hyperparathyroidism

A

Decreased calcium ,increased PTH increased phosphate

36
Q

Mcc of 2 hyperparathyroidism

A

Chronic renal failure

37
Q

Sequence of 2 hyperparathyroidism

A

CRD causes increased phosphate which increased PTH which decrease calcium

38
Q

Renal osteodystrophy is what and where is it found

A

Seconds hyperparathyroidism where excess PTH causes bone lesions

39
Q

Tertiary par hyperthyrodism is after what

A

Renal transplant or efficient renal dialysis where stimulated parathyroid glands remain active

Path Block 2 (19 decks)

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