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Endocrine 1 > Path of Parathyroid > Flashcards

Path of Parathyroid Flashcards

1
Q

What is the most common cause of Primary Hyperparathyroidism? Pathophys?

A

PTG adenoma

autonomous overproduction of PTH not suppressed by neg feedback.

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2
Q

WHat are RENAL charicteristics of HyperCalcemia?

A

Inc renal synth of Vit D => Enhance Ca Abs from gut

Inc reabsorption of Ca in the urine => Hypercalcuria => Kidney Stones (flank pain and hematuria)

Inc urinary excretion of Phosphate

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3
Q

What are the Charic of HyperCalcemia in Bone tract?

A

Bone Reabsorption and Ca mobilization

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4
Q

What is a Brown Tumor?

A

Osteitis Fibrosa Cystica

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5
Q

What is the mneumonic for Clinical correlations of Hyper PTH?

A 
STONES
BONES: Osteomalacia
GROANS: Inc Gastrin
MOANS: Depression, psychosis
Just not feeling right...
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6
Q

What are the charicteristics of Parathyroid Adenoma?

A 
Always SOLITARY
Delicate capsule
Most common in older women
Size ranges from .5-5g(20-40mg normal)
(usually 3 normal and 1 adenoma)
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7
Q

How are ectopic PTH locations found?

A

Tc99 sestamibi nuclear imaging scan

Minimally Invasive Radioguided Parathyroidectomy(MIRP)

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8
Q

WHat is the difference between Histology of PTG Adenoma vs normal?

A

Adenoma: No fat Cells
Primarily Chief Cells
Thin rim of PT tissue
Polygonal chief cells with small centrally placed nuclei with slight variation in nuclear size

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9
Q

WHat are the unique charicteristics of PT Hyperplasia?

A

ALL 4 GLANDS ARE BIG
Lack the usual fat cells
Most common in Pts with MEN syndromes(Multiple Endocrine Neoplasia)
NO RIM of normal PT tissue

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10
Q

What is the cause of PT Hyperplasia?

A

Hypocalcemia from some OTHER cause (Chronic Renal Failure)

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11
Q

What are non-PT causes of HypoCalcemia?

A 
Chronic Renal Failure
Intestinal Malabsorption
Malnutrition
Calcitonin producing tumors (CEA marker)
Rickets
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12
Q

What are the general charicteristics of Parathyroid CA?

A

Low malignancy Potential
50% cured by en bloc resection
late devt of Metastasis

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13
Q

What are the microscopic *** charicteristics of Parathyroid CA?

A

THICK FIBROUS BANDS

mitotic activity

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14
Q

What is the appearance of Parathyroid CA?

A
  1. Cells are uniform and resemble normal PT cells
  2. Cells are arrayed in nodular or trabecular patterns
  3. Cells are enclosed by thick fibrous BANDS
  4. Diagnosis of Cancer based on cytologic detail unreliable
  5. Invasion of surrounding tissues and mets only reliable criteria
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15
Q

What are the causes of Hypoparathyroidism?

A

Autoimmune disorders
Iatrogenic (surgical)
DiGeorge synd

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16
Q

WHat are the S and S of hypocalcemia?

A 
Begins with 
-mental changes
-circumoral paresthesia Chvotek sign
-Trousseau sign
Progresses to 
-Convulsions and 
-Tetany

Endocrine 1 (15 decks)

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