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Endocrine > Parathyroid > Flashcards

Parathyroid Flashcards

1
Q

What is the definition of hyperparathyroidism?

A

Abnormally high levels of PTH secreted in response to low levels of calcium

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2
Q

How is calcium levels in the blood controlled?

A

Via a negative feedback system in response to low calcium that increases secretion of PTH which aims to increase calcium levels

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3
Q

What hormone is released in response to low levels of calcium in the blood?

A

PTH

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4
Q

Where are the 2 areas of action of PTH?

A
  1. Bone

2. Kidneys –> blood vessels

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5
Q

What does PTH do to bone in order to increase calcium levels?

A

Acts on osteoclasts aiming to increase bone breakdown and release calcium in to the blood

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6
Q

What are the 2 ways PTH acting on the kidneys increase calcium level in the blood?

A
  1. Decrease calcium secretion in the urine

2. Activates vitamin D that enhanced absorption of calcium from the intestines

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7
Q

How would calcium and phosphate levels present in a patient suffering from hyperparathyroidism?

A

Hypocalcaemia

Hyperphosphotaemia

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8
Q

What is primary hyperparathyroidism characterised by?

A

Issue with the thyroid gland

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9
Q

What are the 3 causes of hyperparathyroisim?

A
  1. adenoma
  2. hyperplasia
  3. Parathyroid cancer
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10
Q

What account for 80% of primary hyperparathyroidism?

A

Adenoma

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11
Q

What are the 3 causes of secondary hyperparathyroidism?

A
  1. Hypocalcaemia
  2. Low vitamin D
  3. Chronic renal failure
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12
Q

What can happen as a result of over compensatory secretion of PTH from the parathyroid gland?

A

Parathyroid hyperplasia

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13
Q

What causes tertiary hyperparathyroidism?

A

Prolonged secondary hyperparathyroidism that causes hyperplasia and therefore an increase in baseline PTH

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14
Q

What is malignant hyperparathyroidism caused by?

A

Parathyroid related protein produced by some cancers (e.g. lung and breast) that mimics PTH and therefore increases calcium levels

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15
Q

How might an EKG of a patient suffering from hyperparathyroidism present and what does it represent?

A

short QT intervals which is a hallmark for high calcium levels

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16
Q

List 5 symptoms of hyperparathyroidsim?

A
  1. depression
  2. tiredness
  3. polydipsia and polyuria
  4. nausea and loss of appetite
  5. muscle weakness
  6. constipation
  7. loss of concentration
  8. mild confusion
  9. bone fractures
  10. renal stones
  11. dehydration
17
Q

Why might patients with hyperparathyroidism have bone fractures/osteoporosis?

A

Due to increase breakdown of bone

18
Q

Why might patients with hyperparathyroidism have nausea and vomiting?

A

high levels of calcium increases gastric acid levels

19
Q

Why might patients with hyperparathyroidism have renal stones?

A

increased levels of calcium in the kidneys increases the chances of developing renal stones

20
Q

Like 3 complications of hyperparathyroidism?

A
  1. osteoporosis
  2. kidney stones
  3. peptic ulcers
  4. pancreatitis
21
Q

List 2 serious complications of hyperparathyroidism?

A

Cardiac arrhythmia

rapid kidney failure

22
Q

Describe blood results of primary hyperparathyroidism?

A

PTH- high
Calcium- high
Phosphate- low

23
Q

Describe blood results of secondary hyperparathyroidism?

A

PTH- high
calcium- low
phosphate- low

24
Q

Describe blood results of tertiary hyperparathyroidism?

A

PTH- high
Calcium- high
Phosphate- high

25
Q

In primary hyperparathyroidism is PTH response secretion appropriate or inappropriate?

A

Inappropriate

26
Q

In secondary hyperparathyroidism is PTH response secretion appropriate or inappropriate?

A

Appropriate

27
Q

In tertiary hyperparathyroidism is PTH response secretion appropriate or inappropriate?

A

Inappropriate

28
Q

What is the aim of treatment in hyperparathyroidism?

A

To reduce PTH and calcium levels and keep patient hydrated

29
Q

What is the name of the surgical procedure that can be used to treat hyperparathyroidism?

A

Parathyroidectomy

30
Q

What does a parathyroidectomy involve?

A

Removal of the enrlarged areas or of the adenoma

Endocrine (9 decks)

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