Disorders of Ca and PT gland Flashcards

1
Q

Where are CaSR found?

A

PT, kidney, C cells, bone

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2
Q

Causes for hypercalcemia

A

MISHAP (malignancy, intox of VD, sarcoidosis, hyperpara, alkali, pagets

Also Familial hypocalciuric hypercalcemia or meds induced (lithium or HCTZ)

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3
Q

Etiology of primary hyperparathyroidism

A

80-85% adenoma
15% hyperplasia (MEN1, MEN2A)
<1% carcinoma

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4
Q

Epidemiology of hyperparathyroidism

A

women, AA>W>H

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5
Q

Pt with hypercalcemia have what symptoms?#

A

stones, bones, groans psychiatric overtones

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6
Q

What happens to hyperparathyroid in post-kidney transplant or end-stage renal disease

A

Glands become hyperplastic and autonomous

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7
Q

What will PTH be in hypercalcemia due to malignancy and granulomatous disease?

A

Suppressed

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8
Q

Initial treatment of acute hypercalcemia

A

address volume status. Calcitonin, bisphosphonates, GC,

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9
Q

What are the major causes of secondary PTH elevation?

A

Hypocalcemia, hyperphosphatemia, VD deficiency

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10
Q

What happens to VD in renal disease?

A

decrease 1a hydroxylase- decreased active VD

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11
Q

____% of pt with osteoporosis have VD deficiency

A

50

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12
Q

Clinical signs of hypocalcemia

A

trousseaus, chvosteks, hyperreflexia, agitation, convulsions, hypertension, long QT

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13
Q

What are causes of primary hypoparathyroidism?

A

post-thyroidectomy, idiopathic, autoimmune, agenesis (DiGeroge), hypomagnesaemia, hypermag, hyperphosph

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14
Q

Miscellaneous causes of hypocalcemia

A

acute pancreatitis, massive transfusion, tumor lysis, severe sepsis, meds, hungry bone syndrome

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15
Q

What is the clinical manifestation of pseudohypoparathyroidism?

A

elevated PTH, hypocalcemia, hyperphosphatemia, short stature, round face, knuckle knuckle dimple dimple (esp 4th), obesity, Albright’s hereditary osteodystrophy

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16
Q

What is the molecular defect for pseudohypoparathyroidism?

A

inability of PTH to stimulated intracellular events

17
Q

Should we memorize pseudohypoparathyroidism classifications?

A

Nah.

18
Q

Tx of acute hypocalcemic crisis?

A

correct mg. Calcium gluconate

19
Q

Timeline of MEN1 phenotype

A

Hypercalcemia by age 40. Pituitary tumors between 12 and 38. Insulinomas at 25. Gastrinoma at 35

20
Q

Crazy looking tongue is a clinical feature of ____.

A

MEN2B (mucosal neuromas)