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Test 9 > Path 7 Parathyroid > Flashcards

Path 7 Parathyroid Flashcards

1
Q

Normal parathyroid histo

A

Chief cells and fat

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2
Q

PTH regulation

A

++ low free Ca

– high free Ca

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3
Q

PTH function (4)

A
  • Increase osteoclast activity
  • Increase Vitamin D activation -> small bowel Ca, PO4 reabsorption
  • Increase renal Ca reabsorption (distal)
  • Increase renal PO4 excretion (proximal)
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4
Q

Primary hyperparathyroidism

A

Hypercalcemia (usually asymptomatic)

  • Painful Bones (osteitis fibrosa cystica)
  • Renal Stones
  • Abdominal Groans (const, ulcer, gall, pancreatitis)
  • Psychic Moans
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5
Q

Primary hyperparathyroidism lab

A
  • High PTH
  • High Ca
  • Low PO4
  • High urinary cAMP
  • High Alkaline Phosphatase
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6
Q

Main cause of hyperparathyroidism

A

Adenoma (95%)

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7
Q

Main cause of hyperthyroidism

A

Graves

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8
Q

Parathyroid adenoma mutations

A

Cyclin D1

MEN1

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9
Q

Parathyroid adenoma familial syndromes

A

MEN-1
MEN-2
Familial hypocalciuric hypercalcemia: (decreased Ca sensitivity)

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10
Q

Parathyroid adenoma histo

A

Packed with uniform polygonal chief cells, involves one gland

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11
Q

Primary parathyroid hyperplasia

A

Looks like adenoma but involves all 4 glands

-Can be associated to MEN

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12
Q

Secondary hyperparathyroidism

A

Caused by chronic hypocalcemia (renal failure)

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13
Q

Primary v secondary hyperparathyroidism

A

High v Low serum Ca

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14
Q

Calciphylaxis

A

Calcification of vessel walls -> ischemic damage to skin & organs

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15
Q

Renal osteodystrophy

A

High PTH levels cause bone resorption

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16
Q

Tertiary hyperparathyroidism

A

Parathyroid becomes autonomous after chronic secondary hyperparathyroidism

  • Hypercalcemia
  • Tx with parathyroidectomy
17
Q

Congenital hypoparathyroidism

A

DiGeorge syndrome

18
Q

DiGeorge syndrome

A

CATCH-22

  • Cardiac abnormality (fallot)
  • Abnormal facies
  • Thymic aplasia
  • Cleft palate
  • HypoT/HypoPT (aplasia)
  • chromosome 22q11
19
Q

Hypoparathyroidism (hypocalcemia) clinical (4)

A
  • Long QT interval
  • Calcifications of basal ganglia and lens
  • Mental status changes
  • Muscle tetany/spasms
20
Q

Hypocalcemia clinical signs

A

Chvostek sign: facial nerve tapping -> contraction

Trousseau sign: Blood pressure cuff -> carpal spasms

21
Q

Pseudohypoparathyroidism

A

End-organ resistance to PTH

  • Short 4th, 5th digits
  • May show resistance to TSH, FSH/LH as well
22
Q

Pseudohypoparathyroidism labs

A
  • Normal or high PTH
  • Low serum Ca
  • High serum PO4

Test 9 (17 decks)

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