Parathyroid Pathology Flashcards
What are the actions of PTH?
Increase Bone resorption Increase Renal resorption of Ca Increase Renal excretion of P Increase Renal conversion of VitD to active form Increase Gut absorption of Ca
If you have decreased serum calcium, what happens to PTH synthesis?
Increases
What are five causes of hypercalcemia?
Hyperparathyroidism Malignancy (mets, PTH related protein) Vitamin D overdose Thiazide diuretics Milk-alkali syndrome
What is the most common cause of symptomatic hypercalcemia?
Malignancy
What is the most common cause of asymptomatic hypercalcemia?
Hyperparathyroidism
What is secondary hyperparathyroidism due to?
Chronic hypocalcemia (renal failure)
What is tertiary hyperparathyroidism due to?
Autonomous parathyroids
What is pseudohyperparathyroidism?
PTH-related protein from a paraneoplastic syndrome
What are the most common causes of hyperparathyroidism?
Adenoma
Hyperplasia
Carcinoma
What are the signs and symptoms of hyperparathyroidism?
Stones (kidney)
Bones (Pain, brown tumors)
Groans (GI Problems)
Moans (Mental changes)
What are the lab findings in primary hyperparathyroidism?
Increased PTH
Increased Ca
Decreased Phosphate
What are brown tumors?
Microhemorrhages in bone and blood just kinda sits there
What two receptors are implicated in osteoclast stimulation?
RANKL
M-CSF
What are the common genetic defects leading to parathyroid adenoma?
PRAD 1 overexpression (Cyclin D1)
MEN1 loss or mutation
How is parathyroid carcinoma different from adenoma in clinical presentation?
Carcinoma: Abrupt onset of bone pain
