Parathyroid Gland Flashcards
What are the effects of PTH on Ca2+ phosphate
PTH increases calcium through:
- Reduced kidney excretion
- increased reabsorption in the gut
- increase reabsorption in the bone
PTH decreases phosphate through:
- increased Excretion in the kidney
What is the role of vitamin D and calcium
Vitimin D allows calcium to be absorbed in the gut
What is the role of calcitonin
It opposes the actions of PTCH
- reduces bone reabsorption
- reduces osteoclast formation
What are the potential causes of hypercalcemia
- increased dietary intake
- increased production (primary or tertiary adenoma, ectopic tissue, hyperplasia)
- increased vitamin D (TB, sarcoid, diet)
- Malignancy (carcinoma, myeloma)
What are the signs and symptoms of hypercalcemia
MOANS, GROANS, BONES AND STONE!
- Psychic moans (depression)
- Abdominal pain, vomiting, constipation, pancreatitis
- Bone pain and fractures
- kidney stones, CKD/ AKI
+ increased QT interval on ECG
What investigations would you do in hypercalcemia
Bloods:
- Calcium (high)
- phosphate (low)
- PTH (high)
- Alk phos (high)
Bedside:
- 24hr urinary calcium
Imaging:
- Dexa / USS
What is the treatment of hypercalcemia
- Fluids 3-6L
- Bisphosphinates
- or calcitonin for rapid effect
possible furusomide
What are the acute and chronic causes of hypocalcemia
Acute:
- Rhabdomylitis
- Surgery
- Pancreatitis
- Burns
- Sepsis
- respiritory alkalosis
Chronic:
- CKD
- AI
- OVerhydration
What are the signs and symptoms of hypoparathyroidism
SPASMODIC:
S - Spasms (Corpedial or trousseau) P - Perioral parasthesia A - Anxious S - Siezures M - Muscle tone decrease O - Orientation impeded D - Dermatitis and depression I - Impatigo C - Chovostechs sign
What is the treatment of hypoparathyroidism
Mild - Calcium (oral)
Moderate - Alfacalcidol
Severe - calcium gluconate
Acute spasms - Calcium gluconate
Chronic - Oral calcium + vitamin D
