Parathyroid Flashcards
Most common cause of aquired hypooarathyroidism
anterior neck surgery
Patient with hypoparathyroid often complain of
brain fog, lethargy, paresthesia in circumoral area, hands, and feet
what are some more severe manifestations of hypoparathyroidism?
muscle cramps, tetanty, stridor, carpopedal spasm, convulsions, dyspnea
What are two signs seen with hypoparathyroidism?
chvostek sign and trousseau phenomenon
What lab findings will be present in hypoparathyroidism?
low serum calcium
high serum phosphate
low urinary calcium
normal alkaline phosphatase
What is serum calcium largely bound to?
albumin → serum calcium levels must be corrected in hypoalbuminemia
How will PTH levels be affected by hypocalcemia?
low or not elevated
Levels of what electrolyte may exacerbate symptoms and decrease parathyroid function
hypomagnesium and hypermagnesium
In a patient with a parathyroid disorder, what should always be monitored?
serum magnesium
what will be seen on EKG in presence of hypocalcemia?
prolonged QTc
How will hypoparathyroidism appear on CT or radiograph?
more dense bones
basal ganglia calcifications
cutaneous calcifications
How can you prophylactically treat a patient for hypocalcemia after they under go thyroid or parathyroid surgery?
calcitriol and oral calcium
What do you give a patients for emergency treatment for acute hypocalcema (hypoparathyroid tetany)?
airway clearance IV calcium gluconate oral calcium vitamin D preparations magnesium
what is the goal of treating calcium levels in hypoparathyroid patient?
maintain serum calcium levels in slightly lower but asymptomatic range
Vitamin D preparations used in the treatment of hypoparathyroidism
calcitriol
ergocalciferol
cholecalciferol
Most common cause of hypercalcemia
primary hyperparathyroidism
Hyperparathyroidism is caused by the hypersecretion of ___ usually from a ____
PTH
single parathyroid adenoma
What will be elevated in the urine of hyperparathyroid patient?
excessive excretion of calcium and phosphate
secondary and tertiary hyperparathyroid is often seen with
what will the calcium and phosphate levels be?
chronic kidney disease
hyperphosphatemia and decreased ionized calcium
Skeletal manifestations of hyperparathyroidism
loss of cortical bone and gain of trabecular bone
low bone density more prominent in wrist
arthralgia and bone pain
Neuromuscular manifestations of hypercalcemia
paresthesia, muscle cramps and weakness, diminished deep tendon reflexes
CNS manifestations of hypercalcemia
malaise, fatigue, intellectual weariness, insomnia, irritability, depression
Cardiovascular manifestations of hypercalcemia
hypertension, palpitations, prolonged PR interval, shorted QT interval, bradycardia, heart block, asystole
Kidney manifestations of hypercalcemia
polyuria and polydipsia
calcium containing renal calculi
