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Endo > PTH > Flashcards

PTH Flashcards

1
Q

PTH actions

A

Overall increased Ca and decrease PO4
Increase osteoclast activity to Ca and PO4 released from bones
Increase Ca and decrease PO4 reabsorption in kidney
Increase active 1,25 dihydroxy-vitD3 production

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2
Q

1˚ hyperparathyroidism causes

A

80% solitary adenoma
~20% hyperplasia of all glands
<0.5% parathyroid cancer

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3
Q

1˚ hyperparathyroidism presentation

A

Often asymptomatic (not in retrospect) with raised Ca
Raised Ca signs: weak, tired, thirsty, polyuric, renal stones
Bone resorption signs: pain, fractures, osteoporosis
Increased BP

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4
Q

1˚ hyperparathyroidism tests

A 
Inc Ca and PTH
Decreased PO4
Inc ALP
XR shows pepper pot skull, subperiosteal erosions/ cysts
DEXA for osteoporosis
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5
Q

1˚ hyperparathyroidism treatment

A

If mild increase fluid intake to prevent stones
Excision of adenoma/ all 4 parathyroid glands if disease/ ≤50 yrs
Cinacalcet (calcimimetic, inc sensitivity of PT cells to Ca so reduced PTH secretion)

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6
Q

PT gland excision complications

A

Hypoparathyroidism
Hypocalcaemia
Recurrent laryngeal damage

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7
Q

2˚ hyperparathyroidism test results

A

Decreased Ca

Inc PTH appropriately

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8
Q

2˚ hyperparathyroidism causes

A

Decreased vit D intake

Chronic renal failure

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9
Q

2˚ hyperparathyroidism treatment

A

Phosphate binders
Vit D
Cinacalcet if PTH ≥85pmol/L and parathyroidectomy tricky

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10
Q

3˚ hyperparathyroidism test results

A

Increased Ca

Highly increased PTH inappropriately

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11
Q

3˚ hyperparathyroidism causes

A

Occurs after prolonged 2˚, PT glands act autonomously after hyperplastic/adenomatous change
Seen in chronic renal failure

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12
Q

Malignant hyperparathyroidism

A

PT related protein (produced by some squamous cell lung cancers, breast and renal carcinomas) mimics PTH resulting in raised Ca, PTH dec

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13
Q

1˚ hypoparathyroidism presentation

A

Hypocalcaemia signs

Autoimmune comorbidities

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14
Q

What is 1˚ hypoparathyroidism

A

PTH secretion decreased due to gland failure

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15
Q

1˚ hypoparathyroidism causes

A 
Autoimmune
Congenital (Di George syndrome, section of chromosome 22 deletion)
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16
Q

1˚ hypoparathyroidism treatment

A

Ca supplements+ Calcitriol

Synthetic PTH subcut to prevent hypercalcuria

17
Q

2˚ hypoparathyroidism causes

A

Radiation
Surgery
Hypomagnesaemia (Mg needed for PTH secretion)

18
Q

Pseudohypoparathyroidism cause

A

Target cell doesn’t respond to PTH, genetic cause

19
Q

Pseudohypoparathyroidism signs

A

Short metacarpals (4th and 5th mainly)
Round face
Short stature
Calcified basal ganglia

20
Q

Pseudohypoparathyroidism tests

A

Ca decreased
PTH increased
Normal/raised ALP

21
Q

Pseudohypoparathyroidism treatment

A

Same as 1˚ hypoparathyroidism

22
Q

What is pseudopseudohypoparathyroidism

A

Morphological features of pseudohypoparathyroidism with normal features, genetic cause

Endo (6 decks)

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