Parathyroid - Denning Flashcards
what is the parathyroid derived from
descending pharyngeal pouches
PTH activates what process in bones
osteoclasts
PTH activates what process in kidney
reabsorption of Ca
what is the net effect of primary hyper-PTH
bone resorption
renal disease
- incrase ionized Ca
what is the most common sign for primary hyper-PTH
increased ionized Ca
“ painful bones, renal stones, abdominal groans and psychic moans”
where does primary hyper-PTH mets
bones
what is cellularly wrong with primary hyper-PTH
inversion of chromosome 11
what is genetically wrong with MEN I
Chromosome 11q13
- putative suppressor gene
what does adenoma look like with primary hyper-PTH
RIM of compressed normal parathyroid
what does hyperplasia look like with primary hyper-PTH
diffuse enlargement of 2 or more glands
what usually causes hyperplasia primary hyper-PTH
sporadic
MEN I or IIa
how is primary hyper-PTH treated
surgery
What is the number one cause of secondary hyperparathyroidism
renal failure
signs and symptoms of secondary hyperparathyroidism
bone abnormalities
Calciphylaxis: due to increased phosphates
when does tertiary hyperparathyroidism occur
- secondary to hyper-PTH becomes autonomous and excessive
- hyperplasia
- hypercalcemia
what is the primary (idiopathic) cause of hypoparathyroidism
auto-ab’s directed against Ca-sensing receptor
what is a genetic cause of hypoparathyroidism? what is onset presentation
Familial hypoparathyroidism
Candidiasis
signs and symptoms of hypoparathyroidism
Tetany
Chvostek sign
Trousseau sign
Chvostek sign
tap along facial nerve, induce contractions of muscle of eye, mouth or nose
Troussaeu sign
inflate BP cuff, induce carpal spasm, goes away when deflate the cufff
what is the common theme of pseudohypo-PTH disorders
end-organ resistance to normal or elevated PTH
what are defects of pseudohypo-PTH disorders
Pseudohypoparthyroidism Type 1
Pseudohypoparthyroidism Type 2
Pseudohypoparthyroidism Type 1
- dinimished cAMP response to PTH
clinical features of Pseudohypoparthyroidism Type 1
round faces,
short starure
short metacarpal and metatarsal bones
Albright Hereditary osteodystrophy
