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ENRP - Exam 2 > Parathyroid Part 2 > Flashcards

Parathyroid Part 2 Flashcards

1
Q

What are manifestations of Hypocalcemia?

A

Numbness/paresthesias
Muscle cramps, spasms, tetany
Convulsions

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2
Q

What are manifestations of Hypocalcemia?

A

Numbness/paresthesias
Muscle cramps, spasms, tetany
Convulsions

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3
Q

What is a manifestation of Hypocalcemia when taking the blood pressure?

A

Trosseau sign

– hand spasm

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4
Q

What is a manifestation of Hypocalcemia when tapping the facial nerve?

A

Chovstek sign

– elicits spasm

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5
Q

What will be seen on ECG with Hypocalcemia?

A

Prolonged QT interval

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6
Q

Levels of Calcium and PTH with Secondary Hyperparathyroidism?

A

LOW calcium

HIGH PTH

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7
Q

What often causes Secondary Hyperparathyroidism?

A

Renal disease causes low calcium that cannot be fixed –> Elevates PTH

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8
Q

What are 2 renal conditions that are associated with Secondary Hyperparathyroidism?

A

Renal Osteodystrophy

Calciphylaxis

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9
Q

What does Renal Osteodystrophy cause? What appears?

A

Dissecting Osteitis

– “Rugger jersey sign”

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10
Q

What occurs with Calciphylaxis?

A

Calcification and occlusion of blood vessels that leads to ischemia

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11
Q

What causes Tertiary Hyperparathyroidism

A

Prolonged Hypocalcemia that even when fixed, the parathyroid glands cannot stop secreting lots of PTH

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12
Q

With prolonged hypocalcemia, if the parathyroid glands are functioning autonomously, what is the diagnosis

A

Tertiary Hyperparathyroidism

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13
Q

What are 2 acquried causes of Hypoparathyroidism?

A

Iatrogenic - surgical

Autoimmune

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14
Q

Many of the causes of Hypoparathyroidism are congenital. What is Familial Isolated Hypoparathyroidism?

A

The precursor PTH cannot achieve activated mature PTH

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15
Q

The precursor PTH cannot become the mature PTH is what disease that causes Hypoparathyroidism?

A

Familial Isolated Hypoparathyroidism

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16
Q

DiGeorge Syndrome can cause Hypoparathyroidism. Where are the defects during development? What results?

A

3rd and 4th pharyngeal pouches = Hypoplastic Parathyroid Glands

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17
Q

What genetic change is present with DiGeorge Syndrome?

A

Deletion of 22q11.2

18
Q

What are the manifestations of DiGeorge Syndrome?

A

CATCH22

  • Cardiac defects like tetralogy of fallot
  • Abnormal facial features
  • Thymic Hypoplasia
  • Cleft palate
  • Hypocalcemia - due to hypoplastic parathyroid glands
19
Q

What symptoms will the baby manifest that correlate to Hypoparathyroidism with DiGeorge Syndrome?

A

LOW PTH –> LOW calcium –> tetany

20
Q

CATCH 22 DiGeorge syndrome

A 
Cardiac defects
Abnormal face
Thymic hypoplasia
Cleft palate
Hypocalcemia
21
Q

How are CaSR germline mutations inherited?

A

AD

22
Q

What mutation is present with Familial Hypocalciuric Hypercalcemia?

A

Inactivating (Loss of function) CaSR

23
Q

In general, what is happening with Familial Hypocalciuric Hypercalcemia?

A

CaSR thinks there is NOT enough calcium when there actually IS

24
Q

What are the 2 symptoms of the Loss of function mutation is CaSR?

A

(+) PTH = Hypercalcemia

(-) renal excretion = Hypocalciuria

25
Q

What are the 2 symptoms of the loss of function mutation in CaSR?

A

(+) PTH = Hypercalcemia

(-) renal excretion = Hypocalciuria

26
Q

What mutation is present with AD hypoPTH (hypercalciuric hypocalcemia)?

A

Activating (gain of function) CaSR

27
Q

In general what is happening with the activating (gain of function) mutation in CaSR?

A

Thinks there is enough calcium when there is NOT

28
Q

What are the 2 symptoms of the gain of function CaSR mutation?

A

(-) PTH = Hypocalcemia

(+) renal excretion = Hypercalciuria

29
Q

What are the 2 symptoms of the activating mutation with CaSR?

A

(-) PTH = Hypocalcemia

(+) renal excretion = Hypercalciuria

30
Q

Levels of Calcium and PTH with Hypoparathyroidism?

A

LOW

31
Q

What is Pseudohypoparathyroidism?

A

PTH resistance

32
Q

Levels of Calcium and PTH with Pseudohypoparathyroidism?

A

LOW calcium

HIGH PTH – tissues are resistant to it though so manifests hypoparathyroidism

33
Q

What is one disease that can have Pseudohypoparathyroidism?

A

Albright’s Hereditary Osteodystrophy

34
Q

What are the manifestations of Albright’s Hereditary Osteodystrophy?

A

Short, fat and shortened phalanges on all extremities

35
Q

Short, fat and shortened phalanges on all extremities

A

Albright’s Hereditary Osteodystrophy

36
Q

Describe what happens with Pseudohypoparathyroidism?

A

Tissues are not responding to ELEVATED PTH so there is still LOW CALCIUM

37
Q

HIGH PTH and LOW calcium

A

Pseudohypoparathyroidism

38
Q

LOW PTH and LOW calcium

A

Hypoparathyroidism

39
Q

LOW PTH and HIGH calcium

A

Hypercalcemia of Malignancy

40
Q

HIGH PTH and HIGH calcium

A

Hyperparathyroidism (primary)

ENRP - Exam 2 (21 decks)

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