Endo II - Parathyroid Disorders

Question 1

embryonic origin of inferior and superior parathyroid glands

Answer 1

inferior - 3rd arch
superior - 4th arch

Question 2

what are the functions of parathyroid hormone

Answer 2

regulates calcium & phosphorus in bloodstream

Question 3

what are the major regulators of bone mineral homeostasis

Answer 3

vitamin D (1,25-diydroxy-vitamin D) - calciferol
FGF23
PTH

Question 4

what are the minor regulators of bone mineral homeostasis

Answer 4

calcitonin
glucocorticoid
oestrogen

Question 5

function of FGF23

Answer 5

inhibit bone mineralisation via independant klotho pathway phosphouria
suppressing reabsorption at:
intestine- (vit D)
kidney

Question 6

function of calcitonin

Answer 6

lowers serum calcium levels
inhibits osteoclast resorption
in kidney - reduces calcium & phosphate reabsorption

Question 7

glucocorticoid function

Answer 7

antagonise vitamine D
block bone formation
increases renal caclium excretion

Question 8

oestrogen function

Answer 8

prevent accelerated bone loss post-menopause

Question 9

PTH effect on calcium & phsophate in:
intestine
kidney
bone
serum levels

Answer 9

intestine
kidney
bone
serum levels

Question 10

Vit D effect on calcium & phsophate in:
intestine
kidney
bone
serum levels

Answer 10

Question 11

FGF23 effect on calcium & phsophate in:
intestine
kidney
bone
serum levels

Answer 11

intestine
kidney
bone
serum levels

Question 12

symptom mnemonic for hyperparathyroidism

Answer 12

stones
bones
groands
moans
thrones

Question 13

what severe skeletal changes can occur in hyperparathyroidism

Answer 13

dissecting osteitis
osteitis fibrosa
osteitis fibrosa cystica

Question 14

Increased osteolytic activity&raquo_space; subperiosteal erosion osteoclasts boring into the centres of bony trabeculae

Answer 14

dissecting osteitis

Question 15

Osteoblastic new bone trabeculae formation
Bones marrow contains fibrous tissue, haemorrhage and cyst formation (osteitis fibrosa cystica- Brown tumour

Answer 15

osteitis fibrosa

Question 16

hyperparathyroid skeletal changes
Haemorrhage continues, cystic degeneration ultimately occurs

Answer 16

osteitis fibrosa cystica

Question 17

AD, familial
hyperparathyroidism
Rreduced CASR
increased PTH
hypercalcaemia

Answer 17

familial hypocalciuric hypercalcaemia - in parathyroid

Question 18

AD, familial
hyperparathyroidism
Rreduced CASR
increased Ca reabsorption
hypercalcaemia & hypocalciuria

Answer 18

familial hypocalciuric hypercalcaemia - in kidney

Question 19

high PTH
high calcium
low phosphate

Answer 19

primary hyperparathyroidism

Question 20

high PTH
low calcium
high phosphate

Answer 20

secondary hyperparathyroidism

Question 21

high PTH
high calcium
high phosphate

Answer 21

tertiary hyperparathyroidism

Question 22

What is DiGeorge syndrome assoc. with parathyroid

Answer 22

3rd/4th pharyngeal pouch don’t develop
thymus absence

Question 23

muscle spasms
circumoral numbness
chvostek sign trousseau sign
prolonged QT interval

Answer 23

acute hypoparathyroidism

Question 24

mutation affecting GNAS
not obese
no resistance to PTH
mutation from father

Answer 24

pseudopseudohypoparathyroidism

Question 25

mutation affecting GNAS
obese
resistance to PTH
mutation from mother

Answer 25

pseudohypoparathyroidism

Question 26

hypercalcaemia in malignancy caused by

Answer 26

PTHrP