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ENRP - Exam 2 > Parathyroid Part 1 > Flashcards

Parathyroid Part 1 Flashcards

1
Q

Where are the Parathyroid glands and how many of them are there?

A

On the back of the Thyroid = 4 glands

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2
Q

What are the 3 cell types that are within a normal Parathyroid Gland?

A

Chief Cells
Oxyphil Cells
Adipocytes

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3
Q

What cell type in the Parathyroid Gland is central, round and has light pink/white cytoplasm with lots of secretory granules?

A

Chief cells

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4
Q

What cell type in the Parathyroid Gland is smaller with darker nuclei and eosinophilic secretory granules?

A

Oxyphil Cells

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5
Q

Which cell type in the Parathyroid gland is more pink and secretes less material?

A

Oxyphil Cells

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6
Q

What is the main function of the Parathyroid glands?

A

Calcium Homeostasis

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7
Q

What is the main function of the Parathyroid Glands?

A

Calcium Homeostasis

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8
Q

What receptor on the Parathyroid Gland cells can measure Calcium?

A

CaSR = calcium sensing receptor

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9
Q

Parathyroid Glands secrete PTH, to what sources?

A

Bone

Kidney

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10
Q

PTH effect on bone?

A

Bone releases calcium to raise its levels

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11
Q

What 2 things does PTH cause to occur at the kidney?

A
  • Calcium reabsorption and NOT phosphate reabsorption

- Converts 25(OH)D –> 1,25(OH)2D to further mobilize calcium

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12
Q

If there is LOW calcium sensed, what happens?

A

Increased PTH will be released

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13
Q

If there is HIGH calcium sensed, what happens?

A

Less PTH will be released

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14
Q

The normal value for calcium is around what values?

A

9-10

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15
Q

What are the manifestations of Primary Hyperparathyroidism?

A

Bones
Stones - kidney
Groans - abdominal pain
Moans - psychic

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16
Q

Osteoporosis and Osteitis Fibrosis Cystic are manifestations of Primary Hyperparathyroidism. What is the latter?

A

Osteoclast driven bone destruction that causes hemorrhage, fractures and the formation of brown tumors that look metastatic

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17
Q

Abdominal groans with Primary Hyperparathyroidism are due to?

A

Constipation or Gallstones

18
Q

Psychic moans with Primary Hyperparathyroidism are due to?

A

Depression
Lethargy
Seizures

19
Q

What are the symptoms of Primary Hyperparathyroidism due to?

A

CHRONIC hypercalcemia

20
Q

In real life, how is Primary Hyperparathyroidism noticed?

A

LAB WORK

– routine lab work catches elevated calcium and then further workup catches elevated PTH

21
Q

What are 3 causes of Primary Hyperparathyroidism?

A
  1. Adenoma
  2. Primary Hyperplasia
  3. Parathyroid Carcinoma
22
Q

What is the most common cause of Primary Hyperparathyroidism?

A

Parathyroid Adenoma - Benign

23
Q

How many glands are affected with Parathyroid Adenomas?

A

Usually just 1

24
Q

What is a Parathyroid Adenoma?

A

Benign, well circumscribed neoplasm of chief or oxyphil cells

25
Q

What mutation can be present with Parathyroid Adenomas?

A

MEN1

– germline or sporadic

26
Q

Germline mutations are present where?

A

In ALL tissues

27
Q

What will a Technetium scan show with a Parathyroid Adenoma?

A

Disproportionate area of increased uptake that localized to 1 gland

28
Q

How many glands are affected with Primary Hyperplasia?

A

ALL OF THEM

29
Q

With a Parathyroid adenoma and primary hyperplasia, what will be present around them both?

A

Normal parathyroid tissue rim

30
Q

What is the most telltale sign of a Parathyroid Carcinoma?

A

Metastasis

– Angioinvasion and/or Adjacent tissue invasion

31
Q

With the causes of Primary Hyperparathyroidism, you can measure PTH after surgery to see if it is decreasing as normal. If it is NOT decreasing.. what is likely the cause?

A

Parathyroid Carcinoma

32
Q

Levels of Calcium and PTH with Primary Hyperparathyroidism?

A

HIGH

33
Q

What causes Hypercalcemia of Malignancy?

A

Malignancy causing elevated calcium that is NOT parathyroid related

34
Q

Levels of Calcium and PTH with Hypercalcemia of Malignancy?

A

HIGH calcium

LOW PTH

35
Q

When compared to Hyperparathyroidism, how do the symptoms present with Hypercalcemia of Malignancy?

A

More likely to be SYMPTOMATIC with Hypercalcemia of Malignancy

36
Q

In general, which is asymptomatic and which is symptomatic - Primary Hyperparathyroidism vs. Hypercalcemia of Malignancy?

A

Symptomatic = Hypercalcemia of Malignancy

37
Q

What are the symptoms that will present with Hypercalcemia of Malignancy?

A

N/V
Mental status changes
SHORTENED QT interval

38
Q

Mental status changes, N/V and a shortened QT interval… what are you thinking it could be?

A

Hypercalcemia of Malignancy

39
Q

Squamous Carcinomas and Lymphomas can both cause Humoral Hypercalcemia of Malignancy. What do they secrete?

A 
Squamous = PTHrP
Lymphomas = Vitamin D
40
Q

Breast Carcinomas and Myelomas can cause Local Osteolytic Hypercalcemia of Malignancy. What do they do?

A

Cause elevated calcium from direct osteoclastic resorption

ENRP - Exam 2 (21 decks)

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