Parathyroid disorders:Howell

Question 1

Etiology in hyperparathyroidism

Answer 1

-single adenoma in 80-85% of cases
-carcinoma in 2% of cases
-hypercalcemia

Question 2

signs and symptoms of hyperparathyroidism

Answer 2

all due to hypercalcemia and increased osteoclast activity

-Kidneys: stones, polyuria, nocturia
-CV: hypertrophic cardiomyopathy, HTN, chf
-musculoskeletal: nonspecific myalgias, bone loss
-GI: anorexia, nausea, constipation, 15% have peptic ulcers
-CNS: depression
-fatigue overtones
-psychiatric effects

Question 3

hyperparathyroidodism in pregnancy

Answer 3

fetus may have hypoparathyrodism which leads to hypocalcemia bc neg feedback working in fetus

Question 4

what is the first sign of hyperparathyroidism for pregnant women ?

Answer 4

hyperemesis gravidarum: extreme morning sickness

Question 5

treatment of mild primary hyperparathyroidism

Answer 5

monotor calcium, GFR, creatinine, skeletal survery every year as conservative option

Question 6

differential diagnosis for increased calcium

Answer 6

1. cancer
2. dehydration
3. renal failure
4. milk-alkali syndrome(ingestion of ca+ without increased ca excretion )

Question 7

etiology of secondary hyperparathyroidism

Answer 7

-chronic renal failure : results in hypocalcemia, increase in bone loss occurs in attempt to deal with hypocalcemia

-dietary def of calcium or vitam d : PTH increases in attempt to make up for loss of ca

Question 8

signs and sx of secondary hyperparathyroidism

Answer 8

tetany, seizures, prolonged Q-T interval on EKG
renal osteodystrophy: abnormal growth of bone increase in fractures

Question 9

Chvostek’s sign

Answer 9

twitching of facial msucels elicited by lightly tapping at the naterior external auditory meauts

Question 10

Trousseau’s sign

Answer 10

capopedal spasm by occluding the brachial artery

Question 11

Hypoparathyroidism etiology

Answer 11

-usually due to thyroid surgery (iatrogenic)
-rare
-manifestations occur 24-48 hours after surgery

Question 12

sx of hypoparathyroidism

Answer 12

neuromuscular irritability, tetany, muscle cramps

Question 13

labs in hypoparathyroidism

Answer 13

-hypocalcemia and hyperphosphatemia
-prolonged Q-T interval on EKG

Question 14

Pathophysiology of pseudohypoparathyrodism

Answer 14

parathyroid organ in normal but end organs are resitant to PTH

-inherited sundrome

Question 15

labs in pseudohypoparathyroidism

Answer 15

-increased PTH (compensation)
-hypocalcemia
-hyperphosphatemia
-calcification of basal ganglia w/ mental retardation

Question 16

sx of pseudohypoparathyroidism

Answer 16

short stature, round face
calcification of basal ganglia w/ mental retardation

Question 17

what is the inherited syndrome associated with pseudohypoparathyroidism

Answer 17

type 1 albright’s hereditary osteodystrophy