Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine > 4 - parathyroid + calcium disorders > Flashcards

4 - parathyroid + calcium disorders Flashcards

1
Q

how is vitamin D related to calcium & phosphate?

A

vitamin D increases absorption of calcium & phosphate in gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is parathyroid feedback loop?

A
  1. parathyroid gland releases parathyroid hormone (PTH)PTH stimulates→kidneys reabsorb calcium, intestines reabsorb calcium, bones to release calcium. so PTH = high calcium
  2. high calcium = inhibits PTH secretion by calcitonin released by thyroid gland

high calcium =inhibits PTH secretion

low calcium = stimulates PTH secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is primary hyperparathyroidism?

A

high calcium, high PTH

parathyroid dysfunction so too much parathyroid made (and loads keeps being made) which means stimulates loads of calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is secondary hyperparathyroidism?

A

low calcium, high PTH

due to condition outside glands (e.g. vit D deficiency) which lowers calcium, this means parathyroid makes loads of parathyroid hormone to try increase calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is tertiary hyperparathyroidism?

A

high calcium, high PTH

chronic secondary parathyroidism leading to autonomous PTH secretion and cause hypercalcaemia if underlying condition treated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the saying for important symptoms of hypercalcaemia? (like a rhyme)

A

bones, stones, abdominal groans & psychic moans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are some acute and chronic symptoms of hypercalcaemia?

A

acute symptoms = thirst, dehydration, confusion, polyuria

chronic = myopathy, fractures, osteopenia, depression, hypertension, pancreatitis, DU, renal calculi

*bones, stones, abdominal groans, psychic moans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the causes of hypercalcaemia? and what diagnostic biochem levels for each?

A
  1. primary hyperparathyroidism (high calcium, high PTH)
  2. malignancy due to increased osteoclast activity releasing calcium (high calcium, low PTH, high ALP)
  3. drugs (high calcium, low PTH, low ALP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is in diagnosis for primary hyperparathyroidism?

A
  • high serum calcium
  • high or inappropriately normal PTH
  • increased urine calcium excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is management of primary hyperparathyroidism?

A
  1. surgery = only way to actually treat, usually when end-organ damage, under 50 and eGFR above 60
  2. cinacalcet = calcium mimetic (useful if unfit for surgery)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is treatment of hypercalcaemia in malignancy?

A
  • obviously treat the cancer w chemo etc
  • to treat the hypercalcaemia= fluid & rehydrate 4-6L in 24hrs. consider loop diuretics (excretion of Ca), bisphosphonates, steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is sestamibi scan?

A

scan to look at thyroid & parathyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is familial hypocalciuric hypercalcaemia?

A
  • autosomal dominant genetic condition where there’s mutation in calcium sensing receptor (it basically means that can’t sense that too much calcium so don’t pee out just keep absorbing but never gets too high since the receptors still work just like less sensitive)
  • has hypercalcaemia and hypocalciuria (low urinary calcium excretion)
  • don’t need treatment, just get mild hypercalcaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are some symptoms of hypocalcaemia? (think like muscles)

A
  • paraesthesia - fingers, toes, perioral (when hyperventilate)
  • muscle cramps & weakness
  • fatigue
  • bronchospasm & laryngospasm
  • fits
  • chvostek’s sign (tapping over facial nerve)
  • trousseau sign
  • ECG →QT prolongation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is acute treatment of hypocalcaemia?

A

10 ml of 10% IV calcium gluconate over 10 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is long term management of hypoparathyroid?

A

1-2g calcium a day, vit D tablets (alphacalcidol or depot injection like cholecalciferol)

17
Q

what is importance of hypomagnesaemia on calcium & PTH?

A

calcium = needed for muscle contraction, bone health etc

magnesium = helps body release & use calcium properly

when magnesium low →calcium builds up inside cells which messes up calcium functions causing muscle cramps and spasms etc

  • PTH helps control calcium levels, usually low calcium = release PTH but low magnesium stops PTH from being released properly so can’t signal to properly raise calcium
18
Q

what are causes of hypomagnesemia?

A

alcohol, drugs (thiazide, PPI), GI illness, pancreatitis

19
Q

what is treatment of hypomagnesemia?

A

need to replace both magnesium & calcium

20
Q

what is pseudohypoparathyroidism?

A

pseudohypoparathyroidism= rare genetic disorder (Gs alpha subunit, GNAS ) causing body to resists PTH effects (body makes PTH but doesn’t respond to it)

  • has low calcium and high PTH
21
Q

what is presentation of pseudohypoparathyroidism?

A
  • Bone abnormalities (McCune Albright)
  • Obesity
  • Subcutaneous calcification
  • Learning Disability
  • Brachydactyly (shortened 4th metacarpal)
22
Q

what is pseudopseudohypoparathyroidism?

A

same appearance as pseudohypoparathyroidism but with no calcium problems

Endocrine (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions