Pathology Part II Flashcards

(28 cards)

1
Q

These cells regulate free ionized calcium via PTH

A

Chief cells (of the parathyroid)

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2
Q

How to do chief cells regulate ionized calcium?

A
  1. increase bone osteoclast activity - releasing Ca and Phosphate
  2. Increase small bowel absorption of calcium and phosphate (indirect vit D activation)
  3. Increase renal calcium reabsorption (distal tubule) and decrease phosphate reabsorption (proximal tubule)
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3
Q

Increased serum calcium provides this type of feedback to the parathyroid

A

Negative.

Increased serum Ca leads to a decrease in PTH secretion.

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4
Q

Define primary hyperparathyroidism

A

Excess PTH due to a disorder of the parathyroid gland itself

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5
Q

Most common cause of hyperparathyroidism?

A

Parathyroid adenoma (80%)
Sporadic parathyroid hyperplasia
parathyroid carcinoma

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6
Q

How do parathyroid adenomas most often present?

A

benign hypercalcemia

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7
Q

Laboratory findings of hyperparathyroidism?

A
increased PTH
increased Ca
decreased Phos.
Increased urinary cAMP
increase serum alk phos
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8
Q

Most common cause of secondary hyperparathyroidism?

A

Chronic renal failure

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9
Q

Pathophysiology of CRF and secondary hyperparathyroidism?

A

Renal insufficiency - decreased phosphate excretion
Increased serum phosphate - binds free Ca
Decreased free Ca stimulates parathyroid glands
Increased parathyroid gland activity stimulates bone resorption

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10
Q

Lab findings of secondary hyperparathyroidism?

A

Increased PTH
decreased Ca
increased serum phos
increased alk phos

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11
Q

What differences in lab findings will you see between primary and secondary hyperparathyroidism?

A

Primary: Increased Ca, decreased phosphate

secondary: decreased Ca, increased phosphate

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12
Q

List some causes of hypoparathyroidism

A

Autoimmune damage
surgical excision
Di George syndrome

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13
Q

How do symptoms of low serum calcium often present?

A

Numbness and tingling

Muscle spasm

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14
Q

Lab results of hypoparathyroidism

A

Low PTH

Low serum calcium

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15
Q

End organ resistance to PTH (high PTH levels)

A

Pseudohypoparathyroidism

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16
Q

The endocrine pancreas is composed of these types of cells

A

Islet cell cluster
B cells - insulin
A cells - glucagon

17
Q

Insulin MOA

A

upregulates insulin dependent glucose transporter protein (GLUT4) on skeletal muscle and adipose tissue

18
Q

Type I diabetes HLA

19
Q

Etiology of CV disease among diabetics

A

Nonenzymatic glycosylation (NEG) of vascular membranes

20
Q

What number measures the NEG of Hgb (glycated Hgb)

21
Q

Pancreatic endocrine neoplasms often are a component of this endocrine syndrome

A

MEN 1

along with Parathyroid hyperplasia and pituitary adenoma

22
Q

Lab values in pt with insulinoma

A

Decreased serum glucose
Increased insulin
increased C peptide

23
Q

Three layers of adrenal cortex and the hormones they produce

A

Glomerulosa - mineralocorticoids
Fasciculata - glucocorticoids
Reticularis - androgens

24
Q

What are all steroid hormones derived from

25
Primary hyperaldosteronism is most commonly due to this condition
Bilateral adrenal hyperplasia
26
Tx for primary hyperaldosteronism
mineralocorticoid receptor antagonist such as spironolactone or eplerenone if adenoma -- surgically resect
27
Classical presentation for hyperaldosteronism?
HTN Hypokalemia metabolic alkalosis
28
How will Liddle syndrome vary from hyperaldosteronism when running tests
Will have LOW aldosterone