Hypoparathyroidism Flashcards
What are the two types of acquired hypo?
From surgery and autoimmune
Explain the surgery cause?
Accidentally taken out while performing surgery for another purpose
Two things associated with autoimmune hypo?
Candidasis and primary adrenal insufficiency
Explain DiGeorge Syndrome?
Congenital hypo.
Defects in 3 and 4 pharyngeal pouches so the para glands are either absent or not developed well.
What is going on with a patient with CASR gene mutations?
This is an autosomal dominant mutation. The calcium sensing receptor has a gain of function mutation where its too sensitive to calcium so it suppressed PTH leading to low calcium.
What is the main problem with Familial Isolated Hypo?
Patient has a problem getting precursor PTH to mature and functional PTH.
What is the hallmark clinical sign of low calcium?
Tetany or neuromuscular irritability
What are two findings on physical exam that are indicative of low calcium?
Chvostek sign and troussseau sign.
Tap along the facial nerve which will induce contractions of face
Blood pressure cuff blocks circulation of the forearm causing spasms of the wrist.
What are 4 other common clinical signs and symptoms of low calcium?
Mental status changes, calcification of lens and cataracts in the eye, prolonged QT, and dental abnormalities.
Explain what pseudohypopara is and what 3 blood values do we get from it?
We have plenty of PTH but the end organ tissue does not respond to it, PTH isn’t able to elicit its response.
Elevated PTH, low calcium, high phosphate.
What can be associated with pseudohypopara and what is usually the genetic mutation associated with this?
The same tissue is resistance to TSH and FSH/LH.
G protein coupled receptor pathways aren’t working.
