Test Your Knowledge 3 Flashcards
What is myxedema?
Connective tissue changes due to increased mucopolysaccharides and proteins
What are some of the s/s of myxedema?
- boggy, pitting edema
- thickening of tongue and oropharyngeal complex with slurred speech
- bulge sign at the knee
Myxedema: where is the pitting edema commonly seen?
- eyes
- hands
- feet
- supraclavicular area
Myxedema: bulge sign
- dense, viscous synovial fluid at the knee
- may include calcium crystals associated with chondrocalcinosis
Name some common NM manifestations of hypothyroidism
- flexor tenosynovitis with stiffness and accompanies CTS
- fibromyalgia
- inflammatory arthritis
- proximal muscle weakness
- prolonged DTRs
- persistent TrPs
- diffuse aches and cramps
A pt with the dx of hypothyroidism will likely be prescribed with what pharmacological agent?
Synthroid
The side effects of synthroid are negligible.
A. True
B. False
B. False
What are 2 serious potential side effects of Synthroid?
- A-fib
- Osteoporosis
Where are the parathyroid glands? How many does each person possess?
- Within the thyroid
- We have 4 (2 in left lobe, 2 in right lobe)
What is the function of the parathyroid?
Secretes PTH, which regulates calcium and phosphorus metabolism
How does PTH exert its effects?
- Bone demineralization
- increased absorption of calcium and excretion of phosphate by the kidneys
- promoting calcium absorption in GI tract
How does the parathyroid exert an effect on bone demineralization?
Increases release of calcium and phosphate from the bone
What does prolonged and continuous release of PTH cause?
Acceleration of bone breakdown
Normal intermittent PTH enhances
Bone formation
Why are kidney stones prevalent in hyperparathyroidism?
abn PTH production related to release of bone calcium into the bloodstream, leads to kidney damage
- Large amts of phosphorus and calcium excreted and lost through the RENAL system
»»» Deposits of calcium phosphate left in renal tubules »»» kidney stones
What is the medical tx of choice for hyperparathyroidism
Surgery to remove parathyroids
Why is surgery the preferred tx of choice for hyperparathyroidism?
Prolonged effects of hyperparathyroidism can be detrimental to all organ systems
(High serum calcium)
In hypoparathyroidism, insufficient PTH causes serum calcium to be
Decreased
In hypoparathyroidism, insufficient PTH causes serum phosphate to be
Increased
With hypoparathyroidism, the relationship of decreased serum calcium and increased serum phosphate can result in:
Muscular irritability (tetany)
Hypoparathyroidism: acute tetany
This is an emergency
Hyperparathyroidism occurs most commonly with
Postmenopausal women
Hypoparathyroidism is most commonly caused by
- injury
- accidental removal or genetic autoimmune destruction
Hyperparathyroidism: major manifestations
- excessive PTH
- excessive bone demineralization
- excessive calcium in blood
- kidney stones
- decreased bone density/strength
Hypoparathyroidism: major manifestations
- hypocalcemia
- hyperphosphatemia
- NM irritability (tetany)
- cardiac irritability
Describe the interaction between the thyroid and parathyroid, starting with what happens with calcium rises above set point
- Calcium level rises above set point
- Thyroid gland releases calcitonin
- Blood calcium levels fall
- If calcium levels fall below set point, parathyroids release PTH
- Blood calcium levels rise
- If calcium levels rise above set point, thyroid releases calcitonin again.
BOOM
