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Endocrinology > Parathyroid > Flashcards

Parathyroid Flashcards

1
Q

Most common cause of aquired hypooarathyroidism

A

anterior neck surgery

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2
Q

Patient with hypoparathyroid often complain of

A

brain fog, lethargy, paresthesia in circumoral area, hands, and feet

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3
Q

what are some more severe manifestations of hypoparathyroidism?

A

muscle cramps, tetanty, stridor, carpopedal spasm, convulsions, dyspnea

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4
Q

What are two signs seen with hypoparathyroidism?

A

chvostek sign and trousseau phenomenon

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5
Q

What lab findings will be present in hypoparathyroidism?

A

low serum calcium
high serum phosphate
low urinary calcium
normal alkaline phosphatase

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6
Q

What is serum calcium largely bound to?

A

albumin → serum calcium levels must be corrected in hypoalbuminemia

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7
Q

How will PTH levels be affected by hypocalcemia?

A

low or not elevated

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8
Q

Levels of what electrolyte may exacerbate symptoms and decrease parathyroid function

A

hypomagnesium and hypermagnesium

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9
Q

In a patient with a parathyroid disorder, what should always be monitored?

A

serum magnesium

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10
Q

what will be seen on EKG in presence of hypocalcemia?

A

prolonged QTc

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11
Q

How will hypoparathyroidism appear on CT or radiograph?

A

more dense bones
basal ganglia calcifications
cutaneous calcifications

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12
Q

How can you prophylactically treat a patient for hypocalcemia after they under go thyroid or parathyroid surgery?

A

calcitriol and oral calcium

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13
Q

What do you give a patients for emergency treatment for acute hypocalcema (hypoparathyroid tetany)?

A 
airway clearance
IV calcium gluconate 
oral calcium 
vitamin D preparations
magnesium
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14
Q

what is the goal of treating calcium levels in hypoparathyroid patient?

A

maintain serum calcium levels in slightly lower but asymptomatic range

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15
Q

Vitamin D preparations used in the treatment of hypoparathyroidism

A

calcitriol
ergocalciferol
cholecalciferol

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16
Q

Most common cause of hypercalcemia

A

primary hyperparathyroidism

17
Q

Hyperparathyroidism is caused by the hypersecretion of ___ usually from a ____

A

PTH

single parathyroid adenoma

18
Q

What will be elevated in the urine of hyperparathyroid patient?

A

excessive excretion of calcium and phosphate

19
Q

secondary and tertiary hyperparathyroid is often seen with

what will the calcium and phosphate levels be?

A

chronic kidney disease

hyperphosphatemia and decreased ionized calcium

20
Q

Skeletal manifestations of hyperparathyroidism

A

loss of cortical bone and gain of trabecular bone
low bone density more prominent in wrist
arthralgia and bone pain

21
Q

Neuromuscular manifestations of hypercalcemia

A

paresthesia, muscle cramps and weakness, diminished deep tendon reflexes

22
Q

CNS manifestations of hypercalcemia

A

malaise, fatigue, intellectual weariness, insomnia, irritability, depression

23
Q

Cardiovascular manifestations of hypercalcemia

A

hypertension, palpitations, prolonged PR interval, shorted QT interval, bradycardia, heart block, asystole

24
Q

Kidney manifestations of hypercalcemia

A

polyuria and polydipsia

calcium containing renal calculi

25
Q

GI manifestations of hypercalcemia

A

anorexia, nausea, heartburn, vomiting, abdominal pain, weight loss, constipation, obstipation

26
Q

hallmark of primary hyperparathyroidism

A

hypercalcemia

27
Q

What will be elevated in secondary hyperparathyroidism?

A

serum phosphate

28
Q

What lab value will be elevated if there is bone disease present?

A

alkaline phosphatase

29
Q

Patient has low bone density, elevated serum PTH, but normal serum calcium →

A

secondary hyperparathyroidism → vitamin D or calcium deficiency, hyperphosphatemia, chronic kidney disease

30
Q

Patient has low bone density, elevated serum PTH, but normal serum calcium and any cause of secondary hyperparathyroism is rule out, what does the patient have?

A

normocalcemic hyperparathyroidism

31
Q

US can be used to find ____ in parathyroid disease

A

ectopic parathyroid adenomas

32
Q

Most useful method for localizing parathyroid adenomas

A

SPECT [single photon emission CT]

33
Q

Lifestyle modifications that an asymptomatic hyperparathyroid patient should adopt

A

stay active, avoid immobilization, stay hydrated

34
Q

this agent binds to sites of parathyroid glands’ extracellular calcium sensing receptors to increase the glands affinity for extracellular calcium thus decreasing PTH secretion

A

Cinacalcet

35
Q

Cinacalcet is usually well tolerated but may cause

A

nausea and vomiting → transient

36
Q

These agents are potent inhibitors of bone resorption and can temporarily treat the hypercalcemia of hyperparathyroidism

A

IV bisphosphonates

37
Q

Patients with severe hypercalceima due to parathyroid carcinoma

A

Denosumab

38
Q

What is often helpful in treating hyperparathyroid patients?

A

vitamin D replacement

Endocrinology (7 decks)

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