Patho3

Question 1

Renal changes PTH-induced hypercalcemia favors the formation of .. and

Answer 1

urinary tract stones = nephrolithiasis
calcification of the renal interstitium and tubules = nephrocalcinosis

Question 2

secondary to hypercalcemia also may be seen in other sites, including the stomach, lungs, myocardium, and blood vessels

Answer 2

Metastatic calcification

Question 3

Clinical Features of primary hyperthyroidism
Age
gender
Most common manifestation

Answer 3

disease of adults
F > M →gender ratio of nearly 4 : 1
increase in serum ionized calcium

Question 4

most common cause of clinically silent
hypercalcemia.

Answer 4

Primary hyperparathyroidism

Question 5

most common cause
of clinically apparent hypercalcemia in adults

Answer 5

cancer

Question 6

Clinical Features of Primary hyperparathyroidism

Answer 6

secretion of PTH-like polypeptides and osteolytic bone metastases

Question 7

individuals with hypercalcemia caused by parathyroid hyperfunction→
serum PTH is

Answer 7

inappropriately elevated,

Question 8

hypercalcemia caused by nonparathyroid diseases→
serum PTH is

Answer 8

low to undetectable in those including malignancy

Question 9

Other laboratory alterations referable to PTH excess include→

Answer 9

Hypophosphatemia increased urinary excretion of both calcium and phosphate

Question 10

Primary hyperthyroidism traditionally has been associated with a constellation of symptom

Answer 10

painful bones, renal stones, abdominal groans, and psychic moans

Question 11

Additional signs and symptoms that may be encountered in some cases include the
following:
Gastrointestinal disturbances→

Answer 11

constipation, nausea, peptic ulcers, pancreatitis, and gallstones

Question 12

Additional signs and symptoms that may be encountered in some cases include the
following: • Central nervous system alterations→

Answer 12

depression, lethargy, and seizures Neuromuscular abnormalities, including weakness and hypotonia

Question 13

Additional signs and symptoms that may be encountered in some cases include the
following:

Answer 13

Polyuria and secondary polydipsia

Question 14

Secondary hyperparathyroidism is caused by chronic depression of serum
calcium levels, most often as a result of

Answer 14

renal failure→ compensatory
overactivity of the parathyroids.

Question 15

Chronic renal insufficiency is associated with decreased

Answer 15

phosphate excretion which results in hyperphosphatemia

Question 16

in addition, loss of … activity, which is required for the
synthesis of the active form of vitamin D, reduces the intestinal absorption of calcium

Answer 16

renal α1-hydroxylase

Question 17

Alterations of secondary HYPERPARATHYROIDISM causes .. which stimulates

Answer 17

chronic hypocalcemia
activity of the parathyroid glands

Question 18

MORPHOLOGY of secondary hyperthyroidism

Answer 18

The parathyroid glands are hyperplastic
The degree of glandular enlargement is not necessarily symmetric

Question 19

LM of secondary hyperthyroidism

Answer 19

hyperplastic glands contain →
an increased number of chief cells, or cells with more abundant, clear cytoplasm = water-clear cells,
in a diffuse or multinodular distribution fat cells are decreased in number

Question 20

… calcification may be seen in many tissues in secondary hyperthyroidism

Answer 20

Metastatic

Question 21

The clinical manifestations of secondary hyperparathyroidism usually are
dominated by

Answer 21

those related to chronic renal failure

Question 22

Bone abnormalities = renal osteodystrophy and
other changes associated with PTH excess →… severe than those seen in
primary hyperparathyroidism

Answer 22

less

Question 23

Serum calcium secondary hyperparathyroidism

Answer 23

remains near normal

Question 24

The metastatic calcification of blood vessels (secondary to …) occasionally may result in ….

Answer 24

hyperphosphatemia

ischemic damage to skin and other organs=
calciphylaxis

Question 25

In a minority of patients, parathyroid activity may become autonomous and
excessive

Answer 25

tertiary hyperparathyroidism

Question 26

may be necessary to control the hyperparathyroidism in such
patients.

Answer 26

Parathyroidectomy