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Endocrine > Parathyroid hormone and Calcium > Flashcards

Parathyroid hormone and Calcium Flashcards

1
Q

PTH is secreted in response to what?

A

Low ionized Calcium levels

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2
Q

What does PTH do?

A
  1. Increases osteoclast activyt, releasing calcium and phosphate from bones
  2. Increases calcium and decreases phosphate reabsorption in the kidney
  3. Increases active 125 dihydroxy Vit D3
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3
Q

What is the overall effect of PTH?

A

Increases calcium

Decreases phosphate

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4
Q

How does primary hyperparathyroidism present?

A 
1. Increased calcium:
weak, tired, depressed, thirsty, dehydrated, renal stones, abdo pain, pancreatitis, peptic ulcers
2. Bone resorption effects:
pain, fractures, osteopenia/osteoporosis
3. Increased BP
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5
Q

What would blood tests show in primary hyperparathyroidism?

Calcium, PTH, phosphate, ALP and urinary calcium

A 
Increased Calcium
Increased PTH (or normal)
Decreased Phosphate
Increased ALP (bone activity)
Hypercalciuria
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6
Q

What are the treatment options for hyperparathyroidism?

A 
Mild: 
- Increase fluid intake (prevent stones)
- Avoid thiazides, calcium and vit D
- 6 monthly review
Severe:
- Excision of adenoma/glands
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7
Q

What would blood tests show in secondary hyperparathyroidism?
(calcium and PTH)

A

Decreases calcium

Increased PTH

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8
Q

What are the causes of secondary hyperparathyroidism?

A

Chronic renal failure

Reduced Vit D intake

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9
Q

What is the treatment of secondary hyperparathyroidism?

A

Correct cause
Phosphate binders
Vit D
Cinacelet if PTH>85

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10
Q

What would blood tests show in tertiary hyperparathyroidism?

calcium and PTH

A

Increased calcium

Very high PTH

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11
Q

What is the cause of tertiary hyperparathyroidism?

A

Prolonged secondary hyperparathyroidism
> glands act autonomously
PTH is unlimited by feedback control

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12
Q

What is malignant hyperparathyroidism?

A

Some cancers (Squamous cell lung, breast and renal cell carcinomas) may produce parathyroid-related protein

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13
Q

What is primary hypoparathyroidism?

A

Reduced PTH secretion due to gland failure

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14
Q

What would blood tests show in primary hypoparathyroidism?

calcium, PTH, phosphate, ALP

A

Reduced calcium
Reduced PTH
Increased/normal phosphate
Normal ALP

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15
Q

What are the causes of primary hypoparathyroidism?

A

Autoimmune

Congenital (Di George)

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Endocrine (4 decks)

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