Parathyroid Part 2 Flashcards
What are manifestations of Hypocalcemia?
Numbness/paresthesias
Muscle cramps, spasms, tetany
Convulsions
What are manifestations of Hypocalcemia?
Numbness/paresthesias
Muscle cramps, spasms, tetany
Convulsions
What is a manifestation of Hypocalcemia when taking the blood pressure?
Trosseau sign
– hand spasm
What is a manifestation of Hypocalcemia when tapping the facial nerve?
Chovstek sign
– elicits spasm
What will be seen on ECG with Hypocalcemia?
Prolonged QT interval
Levels of Calcium and PTH with Secondary Hyperparathyroidism?
LOW calcium
HIGH PTH
What often causes Secondary Hyperparathyroidism?
Renal disease causes low calcium that cannot be fixed –> Elevates PTH
What are 2 renal conditions that are associated with Secondary Hyperparathyroidism?
Renal Osteodystrophy
Calciphylaxis
What does Renal Osteodystrophy cause? What appears?
Dissecting Osteitis
– “Rugger jersey sign”
What occurs with Calciphylaxis?
Calcification and occlusion of blood vessels that leads to ischemia
What causes Tertiary Hyperparathyroidism
Prolonged Hypocalcemia that even when fixed, the parathyroid glands cannot stop secreting lots of PTH
With prolonged hypocalcemia, if the parathyroid glands are functioning autonomously, what is the diagnosis
Tertiary Hyperparathyroidism
What are 2 acquried causes of Hypoparathyroidism?
Iatrogenic - surgical
Autoimmune
Many of the causes of Hypoparathyroidism are congenital. What is Familial Isolated Hypoparathyroidism?
The precursor PTH cannot achieve activated mature PTH
The precursor PTH cannot become the mature PTH is what disease that causes Hypoparathyroidism?
Familial Isolated Hypoparathyroidism
DiGeorge Syndrome can cause Hypoparathyroidism. Where are the defects during development? What results?
3rd and 4th pharyngeal pouches = Hypoplastic Parathyroid Glands
What genetic change is present with DiGeorge Syndrome?
Deletion of 22q11.2
What are the manifestations of DiGeorge Syndrome?
CATCH22
- Cardiac defects like tetralogy of fallot
- Abnormal facial features
- Thymic Hypoplasia
- Cleft palate
- Hypocalcemia - due to hypoplastic parathyroid glands
What symptoms will the baby manifest that correlate to Hypoparathyroidism with DiGeorge Syndrome?
LOW PTH –> LOW calcium –> tetany
CATCH 22 DiGeorge syndrome
Cardiac defects Abnormal face Thymic hypoplasia Cleft palate Hypocalcemia
How are CaSR germline mutations inherited?
AD
What mutation is present with Familial Hypocalciuric Hypercalcemia?
Inactivating (Loss of function) CaSR
In general, what is happening with Familial Hypocalciuric Hypercalcemia?
CaSR thinks there is NOT enough calcium when there actually IS
What are the 2 symptoms of the Loss of function mutation is CaSR?
(+) PTH = Hypercalcemia
(-) renal excretion = Hypocalciuria
