Brainscape's Knowledge GenomeTM

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


See full index

Pathology > 4th Exam Parathyroid Pathology > Flashcards

4th Exam Parathyroid Pathology Flashcards

1
Q

Inferior parathyroid glands arise from:

A

3rd pharyngeal pouch

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

Superior parathyroid glands arise from:

A

4th pouch

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

all 4 glands are most commonly found here:

A

on posterior thyroid surface

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

Where are migration variants more common?

A

inferior parathyroid glands

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

Superior variants:

A

Retropharyngeal, Retrolaryngeal, Retroesophageal, Mediastinum

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

Inferior variants:

A

Mediastinum, Aortopulmonary window, Jugularcarotid axis, Trachoesophageal groove

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

normal range in mg per gland:

A

< 60 mg per gland, usually 2040mg

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

3 cell types of parathyroid:

A

chief cells, clear cells, oxyphil cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chief cells:

A

Principal cells, Fried egg, Synthesize PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clear cells:

A

Larger than chief cells, more cytoplasm, secrete PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Oxiphil cells:

A

appear after puberty, inc w age, function not clear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens when inc Ca2+ is sensed in the parathyroid?

A

PTH released, effects on bone and kidney

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

parathyroid is responsible for homeostasis of:

A

serum Ca2+ phosphorus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Dec serum Ca2+ effects via parathyroid:

A

stimulates PTH to inc serum Ca2+, negative feedback loop to dec PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Parathyroid Hormone is aka:

A

Parathormone

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

PTH antagonist:

A

calcitonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Calcitonin is secreted by:

A

thyroid parafollicular cells, aka C cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does PTH increases serum Ca2+?

A

Bone: stimulates osteoclasts via RNAK, Kidney: activates vit D which inc GI uptake of Ca, which inhibit phosphate resporption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Increased serum Ca:

A

feedback inhibition PTH secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Increased Vitamin D:

A

feedback inhibition PTH synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

These affect (PTH levels)? renal phosphate resorption:

A

PTH decreases renal phosphorus resorption, Vitamin D increases renal phosphorus resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Secreted by osteocytes in response to hyperphosphatemia:

A

FGF-23

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Function of FGF-23:

A

Increases phosphaturia (phosphate loss in urine) and inhibits 1-a hydroxylase, decreasing Vit D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Case: 62, woman, fatigue, dec energy, weakness, sleeping less, depressed, no hx of cancer or smoking, mild inc BP, no breast or LN masses, no fecal occult blood, Ca+ 11.5 mg/dl, BUN & creatinine normal, “Two-site” assay for PTH: increased (C-terminal, amino terminal), generalized dec bone density, radionuclide sestamibi scan – uptake w “hot spot”, lower L neck, Surgery – L inferior parathyroid gland enlarged, others normal

A

Hyperparathyroidism, parathyroid adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Causes of hypercalcemia:

A

Malignancy, lithium, estrogens, progesterone, Vit D overload, Sarcoidosis, hyperparathyroidism, Alkali syndrome (Ca2+ carbonate supplements, alkaline antacids, sodium bicarbonate), Paget’s disease of Bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Primary Hyperparathyroidism:

A

Parathyroid Adenoma

27
Q

Who are more effected by Parathyroid Adenoma, men or women?

A

women, 3:1

28
Q

Parathyroid Adenoma:

A

50-60yo, 80-85%: adenoma, 15-20%: hyperplasia (2+ glands enlarged)

29
Q

2 preop tests for Parathyroid Adenoma:

A

PTH assay and sestamibi scan

30
Q

Sestamibi scan:

A

@15 min: see all 4 glands, washes out at 2 hours, @2 hours: uptake persists in (metabolically active parathyroid cells of) hyperplasia

31
Q

Intraop test for Parathyroid Adenoma:

A

PTH assay

32
Q

Adenoma is easily confused w:

A

hyperplasia

33
Q

How to distinguish between adenoma and primary hyperparathyroidism:

A

If a section goes thru hilum, might see normal parathyroid tissue, different from the lesion

34
Q

Parathyroid adenoma is histology nonspecific, except if taken here:

A

exactly at hilum

35
Q

TF? There is an inc in intraglandular fat w parathyroid adenoma.

A

F. dec

36
Q

TF? Capsule compressing adjacent tissue causes adenoma.

A

does not make an adenoma

37
Q

Are atypical cells predictive of malignancy?

A

No

38
Q

Parathyroid Adenoma is what type of adenoma?

A

Clear cell adenoma

39
Q

Primary hyperparathyroidism cancers, most to least prevalence:

A

adenoma, hyperplasia, carcinoma

40
Q

Dec chief cell receptors Ca2+ ion sensing:

A

Primary hyperplasia

41
Q

of glands enlarged in parathyroid hyperplasia:

A

2+

42
Q

Most common gastrinoma:

A

Pancreatic islet cell tumors

43
Q

Most common prolactinoma:

A

Pituitary adenoma

44
Q

MEN I PPP is aka:

A

Wermer’s Syndrome

45
Q

MEN I PPP:

A

part of group of disorders, the Multiple Endocrine Neoplasias, affect endocrine system thru development of neoplastic lesions in pituitary, parathyroid gland and pancreas, loss of MEN 1 suppressor gene, Chr 11q11-13, Parathyroid hyperplasia, pancreatic islet cell tumors (most common gastrinoma), pituitary adenomas (most common prolactinoma), adrenal adenomas less common

46
Q

MEN II PPT:

A

Parathyroid hyperplasia, Pheochromocytoma, Thyroid medullary carcinoma

47
Q

Secondary Hyperparathyroidism:

A

Usually chronic renal failure, Inadequate production of active Vit D, red GI absorption of Ca2+, renal retention of phosphate, inc serum phosphate depresses serum Ca2+, compensatory increased PTH, parathyroid hyperplasia, Serum Ca++ usually low normal or low, bone lesions, Histo: fibrosis, hemorrhage, hypertrabecular pattern

48
Q

Tertiary Hyperparathyroidism:

A

Occurs in setting of longstanding secondary hyperplasia, autonomous hyperplasia develops, monoclonal population in one focus, hypercalcemia, Rx: surgery to remove 3+ glands

49
Q

Least common primary hyperparathyroidism:

A

Parathyroid Carcinoma

50
Q

Parathyroid Carcinoma:

A

30-60yo, palpable mass, PTH > 3x normal, profound symptomatic hypercalcemia, may be assoc w prior neck irradiation or hyperparathyroid jaw tumor syndrome, autosomal dominant, mutation HRPT2, central benign fibro-osseus tumors

51
Q

Diagnostic criteria for parathyroid carcinoma:

A

Invasion into surrounding organs, lymphatic or vascular invasion, cytologic pleomorphism and mitotic activity may not be predictive

52
Q

Hyperparathyroidism is assoc w (pneumonic):

A

Stones, Bones, Moans, Groans

53
Q

Stone issues related to hyperparathyroidism:

A

Kidney stones

54
Q

Bone issues related to hyperparathyroidism:

A

Osteoporosis, fractures, brown tumors

55
Q

Moans related to hyperparathyroidism:

A

Depression

56
Q

Groans issues related to hyperparathyroidism

A

GI tract problems

57
Q

Case: 30yo, painful mass in lower L jaw, lethargic, began months ago w slight swelling, inc along w lethargy, swelling - firm to touch, Xray: multilocular radiolucency, incisal biopsy done, histo path showed chronic inflammatory cells w many multi-nucleated giant cells, hemorrhagic areas and hemosiderin, serum Ca2+: 14 mg/dl, PTH: 890 pg/ml

A

Mandibular tumor?

58
Q

Mandibular Tumor:

A

Bone production (membranous, immature bone), not a giant cell tumor, but a giant cell process, brown tumor, loss of lamina dura, root resorption of teeth, complication of hyperparathyroidism

59
Q

Bone Tumor:

A

Circumscribed lytic lesion, hemorrhage, increased vascularity, hemosiderin: brown, inc osteoclastic activity, macs, reparative fibrous tissue, sometimes cystic

60
Q

Dental Consequences of Hyperparathyroidism

A

Bone disease, brown tumor, dec bone density, weak teeth, soft tissue calcifications, loss of lamina dura, widening of PDL, resorption of tooth roots

61
Q

Generalized hyperparathyroidism:

A

Hands: subperiosteal bone resorption, very advanced stage… doesn’t progress this far today due to Ca2+ testing

62
Q

Paget’s Disease of Bone:

A

Disordered bone remodeling, cotton wool appearance, disorganized thickening

63
Q

Tumor Induced Rickets:

A

Osteogenic osteomalacia (softening of bone), FGF-23 induced phosphaturia, FGF-23 can be secreted by a variety of bone and soft tissue tumors, widespread bony lytic lesions, serum PTH, Ca, P normal, inc P and Ca in urine

64
Q

Hypercalcemia in cancer:

A

Paraneoplastic syndrome, squamous ca (lung, esophagus), renal cell ca, serum PTH is low, often secrete PTHrP (related protein), shares 1st 13 AA of PTH, binds to PTH receptors, bone mets, osteoclast activating factors secreted by tumor

Pathology (23 decks)

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