Path 7 Parathyroid Flashcards
Normal parathyroid histo
Chief cells and fat
PTH regulation
++ low free Ca
– high free Ca
PTH function (4)
- Increase osteoclast activity
- Increase Vitamin D activation -> small bowel Ca, PO4 reabsorption
- Increase renal Ca reabsorption (distal)
- Increase renal PO4 excretion (proximal)
Primary hyperparathyroidism
Hypercalcemia (usually asymptomatic)
- Painful Bones (osteitis fibrosa cystica)
- Renal Stones
- Abdominal Groans (const, ulcer, gall, pancreatitis)
- Psychic Moans
Primary hyperparathyroidism lab
- High PTH
- High Ca
- Low PO4
- High urinary cAMP
- High Alkaline Phosphatase
Main cause of hyperparathyroidism
Adenoma (95%)
Main cause of hyperthyroidism
Graves
Parathyroid adenoma mutations
Cyclin D1
MEN1
Parathyroid adenoma familial syndromes
MEN-1
MEN-2
Familial hypocalciuric hypercalcemia: (decreased Ca sensitivity)
Parathyroid adenoma histo
Packed with uniform polygonal chief cells, involves one gland
Primary parathyroid hyperplasia
Looks like adenoma but involves all 4 glands
-Can be associated to MEN
Secondary hyperparathyroidism
Caused by chronic hypocalcemia (renal failure)
Primary v secondary hyperparathyroidism
High v Low serum Ca
Calciphylaxis
Calcification of vessel walls -> ischemic damage to skin & organs
Renal osteodystrophy
High PTH levels cause bone resorption