Parathyroid CIS Flashcards
symptoms of hypocalcemia
twitching, muscle cramps, tingling and numbness
symptoms of hypercalcemia
constipation, polyuria, polydipsia, lethargy, coma, death
Vitamin D’s main action
to promote bone mineralization
PTH-dependent hypercalcemic disorders
Primary hyperparathyroidism (increased PTH)
Hypercalcemia of malignancy
Familial hypocalciuric hypercalcemia
–Heterozygous inactivating mutation in the CaSR
–increased PTH and serum calcium
PTH - independent hypercalcemic disorders
Thiazide diuretics Milk-alkali syndrome Immobilization Acute renal failure Granulomatous disease Vitamin D intoxication Vitamin A intoxication Adrenal insufficiency Hyperthyroidism
the 4 main causes of hypocalcemia for this year
Vitamin D Deficiency
Hypoparathyroidism
Renal Failure
Liver Failure
the key tests in the ddx of hypocalcemia
PTH levels are low in hypoparathyroidism but normal to high in all other causes
Hypomagnesemia impairs PTH secretion and induces PTH resistance in peripheral tissues
Renal disease and liver disease interfere with vitamin D synthesis
Acute pancreatitis causes precipitation of calcium due to the release of lipid products
Hypoproteinemia will reduced total calcium levels but usually do not cause symptoms of hypocalcemia since levels of ionized calcium are typically not altered
parathyroid glands
4 parathyroid glands
- Two superior
- Two inferior
Sit posterior on the thyroid
WHat bone cell types have PTH receptors?
osteoblasts
What is the impact of elevated PTH levels on the kidney
Increased production of 1,25 (OH)2 D3
one way to differentiate between primary hyperparathyroidism and familial?
urine levels of calcium
what does pain on the tibias indicate?
low vitamin D
degrees of vitamin D deficiency
0-10 severe
10-20 moderate
20-30 mild
> 30 normal
Renal osteodystropy (bone problems associated with renal failure) is characterized by:
decrease in 1 alpha hydroxylase activity
Bone loss associated with renal failure occurs in part because:
Renal phosphate clearance decreases in renal failure
phosphate complexes with Calcium and precipitates out
