Endo - Pathology (Parathyroid) Flashcards
What are the 3 types of hyperparathyroidism?
(1) Primary (2) Secondary (3) Tertiary
What is usually the cause of primary hyperparathyroidism?
Usually an adenoma
What is the most prominent lab finding in primary hyperparathyroidism? What are 5 other lab findings?
HYPERCALCEMIA; Hypercalciuria (renal stones), Hypophosphatemia, High PTH, High ALP, High cAMP in urine.
How does primary hyperparathyroidism most often present?
Most often asymptomatic
What are the 4 major ways in which hyperparathyroidism may present, and why?
May present with (1) weakness and constipation (“groans”), (2) abdominal/flank pain (kidney “stones”, acute pancreatitis), (3) depression (“psychiatric overtones”), and (4) Osteitis fibrosa cystia - cystic “bone” spaces filled with brown fibrous tissue (bone pain); All due to hypercalcemia; Think: “Stones, bones, groans, and psychiatric overtones”
What defines Osteitis fibrosa cystica? In what condition is it found?
Osteitis fibrosa cystica - cystic bone spaces filled with brown fibrous tissue (bone pain); Hyperparathyroidism (due to PTH indirect activation of osteoclasts through direct activation of osteoblasts)
What is the pathophysiology of secondary hyperparathyroidism, and what most often cause sit?
Secondary hyperplasia due to decreased gut Ca2+ absorption and increased (PO4)3- , most often in chronic renal disease (causes hypovitaminosis D => decreased Ca2+ absorption)
What is the most prominent lab finding in secondary hyperparathyroidism? What are 3 other lab findings? Using one of these, distinguish how chronic renal failure differs from most other causes of secondary hyperparathyroidism?
HYPOCALCEMIA; Hyperphosphatemia in chronic renal failure (vs. hypophosphatemia with most other causes), High ALP, High PTH
What is tertiary hyperparathyroidism, and what causes it?
Refractory (autonomous) hyperparathyroidism, resulting from chronic renal disesae
What are 2 key lab findings in tertiary hyperparathyroidism?
Very high PTH, High Ca2+
What is renal osteodystrophy, and what causes it?
Bone lesions due to secondary or tertiary hyperparathyroidism due in turn to renal disease
What are 3 causes of hypoparathyroidism?
Due to accidental surgical excision of parathyroid glands, autoimmune destruction, or DiGeorge syndrome.
What are 2 clinical findings of hypoparathyroidism? What are 2 clinical signs associated with this disorder?
Findings: hypocalcemia, tetany; (1) Chvostek sign (2) Trousseau sign
Define Chvostek sign.
Tapping of facial nerve => contraction of facial muscles; Think: “CHvostek = tap the CHeek”
Define Trousseau sign.
Occlusion of brachial artery with BP cuff => carpal spasm; Think: “TRousseau sign = cuff the TRiceps”
