21-parathyroid Gland

Question 0

If parathyroid has very little fat, what does it mean

Answer 0

It is active

Question 1

What cells are in parathyroid and what do they make

Answer 1

Chief cells -PTH

Oxyphil cells

Question 2

What controls the PTH

Answer 2

Free levels of ionized calcium in blood stream

Question 3

How do osteoblasts active osteoclasts

Answer 3

IL-1

Question 4

What is calcium bound to

Answer 4

Albumin
Phosphate
Citrate

Question 5

What gives the negative feedback for PTH

Answer 5

Free ionized calcium

Question 6

What is hypoalbuminemia

Answer 6

Decrease total serum calcium but Norma ionized calcium

So normal PTH

Question 7

When is tetany seen

Answer 7

Only when free ionized levels of calcium are low

Question 8

What does an alkalosis state do to your calcium levels

Answer 8

PTH is high
Bound calcium is increased
Free calcium decreased

Question 9

What are the causes for primary hyperparathyroidsism

Answer 9

Parathyroid adenoma -mc
Parathyroid hyperplasia 2mc
Parathyroid cancer

Question 10

How does primary Hyperparathyrodism occurs

Answer 10

Sporadic or men1 or men 2a

Question 11

How to primary parathyroid labs look like

Answer 11

Increased PTH
Increased Ca
Decreased phosphorus

Question 12

Parathyroid adenoma anatomy

Answer 12

Solitary tumor and other three atrophy

Question 13

Parathyroid hyperplasia anatomy

Answer 13

Whole thyroid involved

Question 14

Parathyroid carcinoma anatomy

Answer 14

Same as adenoma with involvement of one gland and nodular

Only sign is metastasis

Question 15

Mcc of Hypercalcemia in population

Answer 15

Unregulated over production of ptH by gland

Question 16

What is the gland mostly involved in parathyroid adenoma

Answer 16

Right lower parathyroid gland

Question 17

How does the tc99 parathyroid scan show in parathyroid adenoma

Answer 17

There is uptake

Question 18

What glands are involved in parathyroid hyperplasia

Answer 18

All four so very little fat present

Question 19

Symptoms of primary hyperparathyroidism

Answer 19

Bone pain
Renal stones
Abdominal groans
Physics moans

Metastatic calcification a to several areas

Question 20

What does primary hyperparathyroidism lead to in the bone

Answer 20

Brown tumors - bulbous swellings

Question 21

What are brown tumors made of

Answer 21

Osteoclasts and fibroblast form tumor like lesions resembling giant cell tumors of bone - have hermosoderin

Question 22

What does primary hyperparathyroidism do to the kidney

Answer 22

Calcium oxalate renal stones - nephrolothiasis -mc

Nephrocalcinosis - calcification of renal tubules -no ADH -nephrogenic DI

Question 23

What is Nephrocalcinosis - and what does it lead to

Answer 23

In 1 para-hyper calcification of renal tubules -no ADH -nephrogenic DI

Question 24

Most common complain in 1 hyperparathyroidism and why

Answer 24

Constipation because gastrin decreases GI motility

Question 25

Mc presentation in 1hyperparathyrodism

Answer 25

Nephrolothiasis

Question 26

Osteitis fibrosa cystica ?

Answer 26

1hyper parathyroidism cystic and hemorrhagic bone lesions Found in jaw and fingers Eventually rupture blood vessels - leads to brown tumor

Question 27

1hyper PTH bone X-ray

Answer 27

Subperosteal bone resorption | Salt and pepper appearance

Question 28

Cns effects of primary hyper parathyroidism

Answer 28

Depression and seizures

Question 29

Cvs effects of primary hyper parathyroidism

Answer 29

Short qt interval Diastolic hypertension

Question 30

Eye effects of primary hyper parathyroidism

Answer 30

Band keratopathy in the limbus of eyes due to metastatic calcification a

Question 31

What does Ca high low PTH mean And what causes it

Answer 31

Secondary Hypercalcemia Malignancy -scc, rcc Sarcoidosis-vit d hyper Thiazides Hupervotaminosis

Question 32

What does multiple myeloma secrete from plasma cells to cause secondary Hypercalcemia

Answer 32

Il-1

Question 33

Sarcoidosis cause secondary Hypercalcemia by

Answer 33

macrophages in Granuloma secreting 1-alpha hydroxylase leading to hypervotaminosis D -absorb too much calcium so PTH down

Question 34

What does vitamin d do

Answer 34

Increase Jejunum calcium absorption

Question 35

Lab for secondary hyperparathyroidism

Answer 35

Decreased calcium ,increased PTH increased phosphate

Question 36

Mcc of 2 hyperparathyroidism

Answer 36

Chronic renal failure

Question 37

Sequence of 2 hyperparathyroidism

Answer 37

CRD causes increased phosphate which increased PTH which decrease calcium

Question 38

Renal osteodystrophy is what and where is it found

Answer 38

Seconds hyperparathyroidism where excess PTH causes bone lesions

Question 39

Tertiary par hyperthyrodism is after what

Answer 39

Renal transplant or efficient renal dialysis where stimulated parathyroid glands remain active