Test 2 - RU Parathyroid Flashcards
anatomy of the parathyroid
4 lobes located to each of the upper and lower poles of the thyroid
physiology of parathyroid
gland contains chief cells (produce parathyroid hormone) and oxyphil cells
activity of the PTG is controlled by the level of free _____
Ca
low Ca stimulates the gland
High Ca inhibits the gland
metabolic functions of the PTG
activates osteoclasts - removes Ca from bone - increases serum Ca
stimulates the kidney to reabsorb Ca and secrete phosphorus
converts vitamin D to active form - stimulates the kidneys and increases Ca absorption in the GI
primary - autonomous (spontaneous)
most common endocrine disorder
more common in women
95% are sporadic adenomas
bone changes with osteitis fibrosa cystica
gall stones (pancreatitis and steatorrhea)
peptic ulcer (increased Ca stimulates release of gastrin - stimualtes HCL)
primary hyperparathyroidism
secondary
usually chronic renal failure
decreased phosphate excretion
inadequate vitamin D intake
S/S are usually chronic renal failure
secondary hyperparathyroidism
much less common
primary autoimmune atrophy
tetany, neuromuscular irritability
positive Chvostek sign - tapping along the facial nerve
positive trousseau sign - arm cuff with forearm and hand carpal spasm
hypoparathyroidism
type I - diminished cyclic AMP response to PTH, round faces, short stature
type II - blunded PTH response, hypocalemia results in PTH hyperfunction
psuedohypoparathyroidism