Parathyroid Pathology

Question 1

Embryology of parathyroid glands

Answer 1

upper pair: from 4th pharyngeal pouch

lower pair: from 3rd pharyngeal pouch

Question 2

PTH secreted from this cell type

Answer 2

chief cells

Question 3

1˚, 2˚, 3˚, and pseudohyperparathyroidism

Answer 3

1˚: pituitary adenoma
2˚: due to chronic hypocalcemia
3˚: autonomous parathyroids
pseudohyperparathyroidism: PTHrp from ectopic cancer, usually squamous cell lung

Question 4

Most common causes of hyperparathyroidism

Answer 4

adenoma > hyperplasia > carcinoma

Question 5

Sx of hyperparathyroidism

Answer 5

stone: kidney stones
bone: bone pain, brown tumors
groan: GI problems
moan: mental changes

Question 6

Labs in 1˚ hyperparathyroidism

Answer 6

elevated PTH and Ca2+

low serum phosphate

Question 7

Osteitis fibrosa cystica

Answer 7

longstanding hyperparathyroidism

punched out lesions in skull

Question 8

Most common cause of 2˚ hyperparathyroidism

Answer 8

renal failure

cannot excrete phosphate –> hypocalcemia

Question 9

Chvostek sign

Answer 9

twitch in cheek when tap on face

due to low serum calcium

Question 10

Trousseau sign

Answer 10

arm spasms when BP cuff put on

and tightened

Question 11

Severe hypocalcemia problems

Answer 11

arrhythmias, also dental abnormalities