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My Endocrinology > Parathyroid > Flashcards

Parathyroid Flashcards

1
Q

What action does Vitamin D have?

A

25-hydroxylase —kidney—> 1,25 (OH)2D

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2
Q

What is the calcium-sensing receptor?

A

GPCR that helps to regulate extracellular calcium homeostasis
when calcium is sensed there is negative feedback to reduce PTH level

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3
Q

What are the acute effects of hypercalcaemia?

A
  • thirst
  • dehydration
  • confusion
  • polyuria
    (DI)
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4
Q

What are the chronic effects of hypercalcaemia?

A
  • myopathy
  • fractures
  • depression
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5
Q

What are the causes of hypercalcaemia with a low PTH?

A

bone pathology

  • with high ALP is mets or sarcoid
  • with low ALP is myeloma
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6
Q

What are the causes of hypercalcaemia with high or normal PTH?

A
  • high Urinary calcium is primary hyperparathyroidism

- low Urinary calcium is FHH

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7
Q

What are the most common causes of hypercalcaemia?

A

primary hyperparathyroidism

malignancy

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8
Q

What is the diagnosis of hypercalcaemia based on?

A
  • raised serum calcium
  • raised serum PTH (or inappropriately normal)
  • high urine calcium excretion
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9
Q

What is the high ALP due to in malignancy?

A
  • metastatic bone destruction
  • PTHrp from solid tumours
  • osteoclast activating factors
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10
Q

What is the acute treatment for hypercalcaemia?

A
  • fluids
  • ?loop diuretics (not thiazides)
  • bisphosphonates to lower Ca
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11
Q

What are the treatment options for primary hyperparathyroidism?

A
  • surgery: if v high Ca, below 50y, bad kidney function and end organ damage eg bone disease
  • if no to surgery, give cincacalet
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12
Q

What must be done before surgery for primary hyperparathyroidism?

A

a sestamibi scan

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13
Q

What is primary hyperparathyroidism?

A
  • primary overactivity of parathyroid gland ie adenoma

- high calcium and high PTH

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14
Q

What is secondary hyperparathyroidism?

A
  • physiological response to low calcium and vit D

- low calcium and high PTH

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15
Q

What is tertiary hyperparathyroidism?

A
  • parathyroid becomes autonomous after years of overactivity
  • high calcium and high PTH
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16
Q

What is the parathyroid issue that patients with MEN1+2 always get?

A

parathyroid adenoma with hypercalcaemia at a young age

17
Q

What is FHH?

A

Familial hypocalciuric hypercalcaemia needs higher levels of calcium to put PTH down resulting in high serum calcium and low urine calcium

18
Q

What are the features of FHH?

A
  • autosomal dominant
  • familial
  • benign
  • genetic screening
19
Q

What are the features of hypocalcaemia?

A
  • long QT
  • fitting
  • paraesthesia of the toes and fingers
  • muscle cramps
  • muscle weakness
  • bronchospasm
  • Chovsteks sign which is twitching of the facial muscles when the facial nerve is tapped
20
Q

What are the causes of hypoparathyroidism?

A
  • DiGeorge
  • Autoimmune
  • Idiopathic
  • Hypomagnesaemia
21
Q

What can cause high intracellular calcium?

A

low magnesium as release of calcium is dependent on magnesium

22
Q

What are the causes of hypomagnesemia?

A
  • alcohol
  • drugs
  • GI illness
  • pancreatitis
  • malabsorption
23
Q

What is pseudohypoparathyroidism?

A

due to PTH resistance so high PTH but low calcium and this is in short and fat patients

24
Q

What does the sun do to form vit D?

A

sun acts on cholesterol which forms D3 which goes to the liver and then the kidney to become active

25
Q

What are the causes of vit D deficiency?

A
  • drugs
  • lack of sunlight
  • chronic renal failure
  • malabsorption
  • dietary
26
Q

What are the features of osteomalacia?

A

adult vit D deficiency

  • proximal myopathy (hands over heads, get out of chair and up stairs)
  • bad dentition
  • tender bones
  • waddling gait
27
Q

What does chronic renal disease lead to?

A

vit D deficiency and secondary hyperparathyroid

28
Q

What can long term low vit D lead to?

A
  • fractures
  • rickets
  • malignancy (particularly of the colon)

My Endocrinology (12 decks)

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