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Renal and Endocrine > 2.4.3 Parathyroid and Calcium Homeostasis > Flashcards

2.4.3 Parathyroid and Calcium Homeostasis Flashcards

1
Q

And this one!

A

Post surgical hypoparathyroidism

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2
Q

Look at the following case and tell me what they have

A
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3
Q

Draw a graph showing the relationship of Ca2+ and PTH.

A
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4
Q

What cells release parathyroid hormone?

A

Parathyroid chief cells

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5
Q

How would you treat someone with hypoparathyroidism?

A

Calcium supplementation

Calcitriol - 1, 25 dihydroxy vitamin D

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6
Q

What is the mutation in familial hypoparathyroidism with hypercalcuria?

A

Activating mutation of the CSR

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7
Q

What are the characteristics of hypoparathyroidism?

A

Hypocalcemia

Inappropriately low PTH

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8
Q

What is primary hyperparathyroidism?

A

Elevated calcium with inappropriately normal or elevated PTH

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9
Q

What are the characteristics of primary hyperparathyroidism?

A
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10
Q

A vitamin D excess can lead to?

A

Hypercalcemia and Hypercalciuria

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11
Q

What does this patient have?

A

Low PTH

Elevated PTHrp

Breast CA dx

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12
Q

When chronically stimulated how will chief cells respond?

A

They will replicate

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13
Q

Look at the following case and tell me what is going on

A

Patient has high PTH

Low Urine calcium

It is FHH

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14
Q

How can sarcoidosis lead to kidney stones?

A

Sarcoid granuloma increases calcitriol which will increase Ca GI absorption

Increase serum Ca and increase excretion in the kidney

STONES!

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15
Q

What would FHH do to levels of Mg and urine calcium?

A

Mg - increased

Urince calcium - decreased

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16
Q

How does PTH act on the bone?

A

It acts directly on the bone to stimulate calcium reabsorption

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17
Q

A mutation in the Parathyroid Calcium-Sensing Receptor leading to?

A

Familial hypocalciuric hypercalcemia (FHH)

or

Familial hypoparathyroidism with hypercalciuria

18
Q

What is the mechanism of action of calcitonin?

A

Decreases tubular reabsorption of calcium

Inhibits osteoclast mediated bone reabsorption

19
Q

How would PTH respond to decreasing levels of 25 OHD?

A

PTH will rise to stimulate conversion of 25OHD to 1,25OH2D3

This will maintain intestinal absorption of calcium

20
Q

32 y/o male with Chron’s disease ⇒ hypocalcemia related to malabsorption. Will PTH be increased or decreased?

A

Increased

21
Q

How do you defend against bone loss?

A
22
Q

Draw a schmatic on how PTH affects:

Bone

Kidneys

Intestine

A
23
Q

What is calcitriol?

A

Hormonally active Vitamin D - will act to raise blood calcium levels

24
Q

54 y/o female with breast cancer ⇒ hypercalcemia secondary to PTHrP. Will PTH be increased or decreased?

A

Decreased

25
Q

What are some consequences of Vitamin D deficiency?

A
26
Q

What does familial hypoparathyroidism with hypercalcuria do to PTH and urine calcium levels?

A

PTH - decreased

Urine calcium - increased

27
Q

Look at this one too!

A

Low PTH

Elevated 1,25 (OH)2D3

CXR for lymphoma or sarcoidosis

28
Q

What is the role of calcitriol on the synthesis of PTH?

A

Inhibits PTH synthesis by interacting with VDR

29
Q

How quickly do levels of parathyroid hormone respond to changes in calcium?

A

Rapid secretion of PTH allows for quick response of PTH to changing levels

30
Q

How would FHH effect levels of PTH and calcium?

A

Increase PTH

Increase Calcium

31
Q

This one!

A
32
Q

What is the mutation in FHH?

A

Inactivating mutation of the CSR

33
Q

How does PTH act on the kidney in regards to phosphate?

A
34
Q

Calcitonin is secreted by?

A

C cells

35
Q

Where is calcitonin produced?

A

Within C cells of the thyroid gland

36
Q

What does familial hypoparathyroidism with hypercalcuria do to levels of serum calcium?

A

Decrease

37
Q

How does PTH respond to hyperphosphatemia?

A

Increases

38
Q

How would you treat a patient with Primary Hyperparathyroidism?

A

Surgery

or

Cinacalcet - increases chief cell CSR sensitivity to calcium - decreasing PTH

39
Q

Following a parathyroidectomy she developed hypocalcemia on Post-OP day 1. Labs Revealed:

A

This is hungry bone syndrome

40
Q

What is the role of PTH on Vitamin D?

A

PTH stimulates renal synthesis of 1,25 dihydroxyvitamin D which is a hormone that stimulates GI calcium reabsorption (making calcitriol)

Renal and Endocrine (46 decks)

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