Parathyroid and Ions Flashcards by Thomas Eraifej | Brainscape

Q

Role of parathyroid hormone (PTH)

A

Bone resorption

Increase Ca reabsorption in kidney

Decrease PO4 reabsorption in kidney

Stimulates vit D

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Q

Role of vit D

A

Increase Ca and PO4 absorption in gut

Increase Ca and PO4 reabsorption in kidney

Bone turnover

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Q

Role of calcitonin

A

Reduces Ca and PO4

Absorbed into bone

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Q

Site of calcitonin release

A

C cells of thyroid

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Q

Effect of Mg on Ca

A

Low Mg inhibits PTH release

May cause hypocalcaemia

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Q

Features of hyercalcaemia

A

Bones, stones, abdo groans and psychic moans

Bone pain, #s

Renal stones

Abdo pain, constipation, N/V

Confusion, weakness

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Q

Mx of acute hypercalcaemia

A

Rehydrate

Bisphosphonate

Treat cause

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Q

Features of hypocalcaemia

A

Cramps

Spasms

Neuromuscular excitability

Trousseau’s sign

Chvostek’s sign

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Q

Trousseau’s sign

A

Inflate BP cuff

Wrist and fingers flex

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Q

Chvostek’s sign

A

Tap facial nerve over parotid

Corner of mouth twitches

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Q

Sx of severe hypophosphataemia

A

Muscle weakness

Rhabdomyolysis

RC, WC, PLT dysfunction

Arrhythmias

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Q

Sx of hypomagnesaemia

A

Paraesthesia

Ataxia

Seizures

Tetany

Arrhythmias

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Q

Sx of severe hypermagnesaemia

A

Neuromuscular depression

Low BP

Bradycardia

Respiratory depression

Coma

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Q

Sx of zinc deficiency

A

Alopecia

Dermatitis

Night blindness

Diarrhoae

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Q

Causes of primary hyperparathyroidism

A

Solitary adenoma ~80%

Hyperplasia

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Q

Ix for primary hyperparathyroidism

A

High Ca

High PTH

Low PO4

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Q

Mx of hyperparathyroidism

A

Fluid intake to prevent renal stones

Avoid thiazides

Excision of adenoma

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Q

Indications for excision of parathyroid adenoma

A

High Ca

Osteoporosis

Renal stones

Reduced renal function

Age < 50 yrs

Q

Multiple Endocrine Neoplasia (MEN) inheritance

A

Autosomal dominant

Q

MEN 1

A

Parathyroid adenoma

Pancreas tumour

Pituitary prolactinoma

Q

MEN 2a

A

Parathyroid tumour

Medullary Thyroid cancer

Phaeochromocytoma

Q

MEN 1 gene

A

Tumour suppressor gene

Q

MEN 2b

A

Medullary thyroid cancer

Phaechromocytoma

Mucosal neuromas

Marfanoid features

Q

MEN 2a and b gene

A

ret proto-oncogene

Receptor tyrosine kinase

Q

Definition of secondary hyperparathyroidism

A

Low Ca leads to increase in PTH

Q

Causes of secondary hyperparathyroidism

A

Vit D deficiency

CKD

Q

Rx of secondary hyperparathyroidism

A

Treat cause

Vit D

Q

Tertiary hyperparathyroidism definition

A

Prolongued secondary hyperparathyroidism

Parathyroid glands become hyperplastic

High PTH despite high Ca

Q

Causes of tertiary hyperparathyroidism

A

CKD

Q

Definition of malignant hyperparathyroidism

A

Cancers produce PTHrP

(Parathyroid related protein)

Q

Cancers causing malignant hyperparathyroidism

A

Squamous cell lung cancers

Breast

Renal cell carcinomas

Q

Primary hypoparathyroidism definition

A

Gland failure

Low PTH

Q

Ix for primary hypoparathyroidism

A

Low Ca

Low PTH

High PO4

Q

Causes of primary hypoparathyroidism

A

Autoimmune

Congenital (DiGeorge)

Q

Rx of primary hypoparathyroidism

A

Ca

Synthetic PTH

Q

Causes of secondary hypoparathyroidism

A

Radiation

(Para) thyroidectomy

Hypomagnesaemia

Q

Pseudohypoparathyroidism definition

A

Failure to respond to PTH

Q

Signs of pseudohypoparathyroidism

A

Short metacarpals

Round face

Short stature

Low IQ

Calcified basal ganglia

Q

Cause of pseudohypoparathyroidism

A

Genetic

Q

Definition of pseudopseudohypoparathyroidism

A

Same as pseudohypoparathyroidism

But normal biochemistry

Genetic cause

Q

Von Hippel-Lindau syndrome inheritance

A

Autosomal dominant

Q

Von Hippel-Lindau syndrome mutation

A

Tumour suppressor gene

Q

Von Hippel-Lindau syndrome features

A

Predisposes to bilateral renal cysts

Retinal haemangioblastoma

Cerebellar haemangioblastoma

Phaeochromocytoma

Q

Risk of renal cysts in Von Hippel-Lindau syndrome

A

Risk of transformation to renal cell cancer