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endocrinology lectures phase 2 > calcium and parathyroid hormone > Flashcards

calcium and parathyroid hormone Flashcards

1
Q

actions of parathyroid hormone

A
  • Increased Ca2+ reabsorption in the kidney
  • Increased 1 alpha-hydroxylation of 25-OH vitamin D in the kidney
  • Decreased phosphate reabsorption in the kidney
  • Increased bone remodelling (bone resorption greater than bone formation)
  • Indirectly increases Ca2+ reabsorption in the intestine
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2
Q

what is hypocalcemia

A

Low total serum calcium

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3
Q

consequences of hypocalcaemia

A

Paraesthesia
Muscle spasm
Seizures
Basal ganglia calcification
Cataracts
ECG abnormalities (long QT)
Causes osteomalacia – vitamin D deficiency

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4
Q

what is corrected calcium

A

total serum calcium + 0.02

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5
Q

what is Chvostek’s sign

A

tap over facial nerve and look for spasm of facial muscles

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6
Q

what is hypoparathyroidism

A

Underproduction of parathyroid hormone.

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7
Q

causes of hypoparathyrodism

A
  1. Genetics – recessive, dominant, X-linked
  2. Autoimmune – isolated, polyglandular type 1
  3. Infiltration of the parathyroid glands by iron overload (hemochromatosis)
  4. Surgery - parathyroidectomy (removal of parathyroid glands)
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8
Q

what is Pseudohypoparathyroidism

A

Resistance to parathyroid hormone

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9
Q

what is calcium like in Pseudohypoparathyroidism

A

Normal calcium metabolism
Low serum calcium and high phosphate but appropriate PTH level for the low calcium

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10
Q

consequnces of Pseudohypoparathyroidism

A

Short stature
Obesity
Round faces
Mild learning difficulties
Short fourth metacarpals
Other hormone resistance

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11
Q

define hypercalcaemia

A

High calcium levels in the blood serum (>2.66mmol/L)`

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12
Q

what can cause hypercalcaemia

A

by tourniquet on for too long

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13
Q

symptoms of hypercalcaemia

A

Thirst
Polyuria
Nausea
Constipation
Confusion
Can lead to coma

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14
Q

consequences of hypercalcaemia

A

Malignancy (lymphoma)
Primary hyperparathyroidism
Thiazides
Sarcoidosis

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15
Q

what is primary hyperparathyroidms

A

Increased PTH levels usually due to a tumour within the parathyroid gland

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16
Q

consquences of primary hyperparathyroidism

A

Bones – osteitis fibrosa cystica, osteoporosis

Kidney stones

Psychic groans – confusion

Abdominal moans – constipation, acute pancreatitis

17
Q

PTH, Calcium, phosphate levels in Vitamin D deficiency (secondary hyperparathyroidism

A

PTH - high

calcium - low

phosphate - low

18
Q

PTH, Calcium, phosphate levels in Hypoparathyroidism (underactive parathyroid)

A

PTH - low

calcium - low

phosphate - high

19
Q

PTH, Calcium, phosphate levels in Pseudohypoparathyroidism (hypocalcaemia - PTH resistance)

A

PTH - high

calcium - low

phosphate - high

20
Q

PTH, Calcium, phosphate levels in Pseudopseudohypoparathryoidism (pseudo phenotype, Ca metabolism normal)

A

PTH - normal

calcium - normal

phosphate - normal

21
Q

PTH, Calcium, phosphate levels in Hypercalcaemia of malignancy

A

PTH - low

calcium - high

phosphate - Unpredictable - depends on underlying cause

22
Q

PTH, Calcium, phosphate levels in Primary hyperparathyroidism

A

PTH - high

calcium - high

phosphate - low

23
Q

PTH, Calcium, phosphate levels in tertiary hyperparathyrodism

A

PTH - high

calcium - high

phosphate - high

24
Q

is PTH appropiate in Vitamin D deficiency (secondary hyperparathyroidism

A

yes

25
Q

is PTH appropiate in Hypoparathyroidism (underactive parathyroid)

A

no

26
Q

is PTH apprioiate in Pseudohypoparathyroidism (hypocalcaemia - PTH resistance)

A

yes

27
Q

is PTH appropiate in Pseudopseudohypoparathryoidism (pseudo phenotype, Ca metabolism normal)

A

n/a

28
Q

is PTH appropiate in Hypercalcaemia of malignancy

A

yes

29
Q

is PTH appropiate in Primary hyperparathyroidism

A

no

30
Q

is PTH appropiate in tertiary hyperparaythyroidism

A

no

31
Q

when are changes in PTH appropiate

A

To maintain calcium balance

32
Q

when are changes in PTH inappropiate

A

they Cause calcium imbalance

33
Q
A

endocrinology lectures phase 2 (17 decks)

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