Chapter 24- Parathyroid Flashcards Preview

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Flashcards in Chapter 24- Parathyroid Deck (53)
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1

What is the result of using PTH during surgery in the cause of parathyroid carcinoma

Does not go down during or after surgery

2

In the case of a solitary parathyroid adenoma, what is the effect on the other parathyroid glands

Usually shrunken, because the increased PTH production from the adenoma will cause a feedback and stop production from the other glands

3

What is the likely diagnosis with:
-Low calcium
-High PTH

-Secondary hyperparathyroidism

4

What is the pathogenesis of pseudohypoparathyroidism

-Receptors are resistant to PTH, so low levels of calcium even in the presence of high levels of PTH

5

Where are the parathyroid glands located

4 spots on the back of the thyroid

6

What are the histological findings in the cause of parathyroid hyperplasia

-Lack of adipocytes without a normal rim of parathyroid tissue

7

What is the usual histological finding in the cause of a parathyroid adenoma

Abnormal tissue right directly next to normal tissue

Abnormal tissue: will have the secretory Chief cells with a follicular architecture, absence of adipose cells

Normal: Will contain chief cells, oxyphil cells, and Adipocytes

8

What are the bodily responses to PTH release from the parathyroid glands

-Calcium release from bone
-Vitamin D production in the kidney
-phosphate excretion form the kidney
-Calcium absorption in the gut

9

What are the clinal presentations of a patient with Digeorge syndome

-Lack of adaptive immunity (no thymus)
-Cardiac abnormalities
-Hypocalcemia (no parathyroids)

10

What is the major cause of primary hyperparathyroidism

Adenomas (85-95%)

11

What is the likely diagnosis with:
-Low calcium
-Low PTH

Hypoparathyroidism

12

What is the scan done to look for a parathyroid adenoma

Technetium scan of the parathyroid gland, where there will be an increased uptake if there is an adenoma

13

What is the telltale sign used to help differentiate parathyroid carcinoma

Metastasis***
-Also invasion into adjacent tissues
-Vascular invasion

14

What are the parathyroid tumors seen with mutations in MEN 1

Parathyroid adenomas

15

What is the meaning of the primary hyperparathyroidism saying renal stone

Nephrolithiasis

16

What is the meaning of the primary hyperparathyroidism saying psychic moans

-Depression
-weakness/fatigue
-Seuzures

17

What are the causes of parathyroid hyperplasia

-MEN syndromes can be present
-Secondary hyperplasia is most common *

18

Pathogensis of sarcoidosis causing hypercalcemia

Increases vitamin d producing, resulting in calcium absorption from the intestines

19

What are the potential abnormal causes of raised PTH

-Hyperparathyroidism (most likely primary adenoma)
-Familial hypocalciuric hypercalcemia (hyper sensitive calcium sensing receptors)

20

What are the signs for hypocalcemia

-Muscle cramps and spasms (tetany)
-Trousseau sign (blood pressure cuff induces hand movements)
-Chvostek sign (tapping trigeminal nerve induces a twitch)

21

What are the causes of secondary hyperparathyroidism

-Renal failure (cant convert to Vit D)
-Vitamin D deficiency
-Pseudohypoparathyroidsm

22

What are the general findings in osteitis fibrosis cystica

-Starts as a cystic brown tumor***
-Osteoclasts bone destruction
-Small Fractures
-Hemorrhae and reactive tissue

23

What are the congenital conditions commonly leading to hypoparathyroidism

-Digeorge syndrome
-CASR germline mutations
-Familial isolated hypoparathyroidism

24

What is the likely diagnosis with:
-High Calcium
-Low PTH

-Humoral hypercalcemia of malignancy
-other PTH independent cause

25

What is renal osteodystrophy

Dissecting osteitis in secondary hyperparathyroidism, in which loss of bone density

26

What are the potential abnormal causes of decreased PTH

-Hypercalcemia of malignancy (PTHrP or a PTH analog from a malignancy is being produced)
-Vitamin D toxicity
-Immobilization
-Granulomatous disease (sarcoidosis)
-Thiazide diuretics

27

When there is hyperparathyroidism due to anything other than a primary cause, what is the end result

Multifocal hyperplasia of the parathyroid glands

28

What is the pathogensis of familial isolated hypoparathyroidism

Precursor PTH can not become functional, resulting in hypoparathyroidism

29

What are the causes of tertiary hypocalcemia

Autonomous function of the parathyroud gland due to prolonged hypocalcemia

30

What are the common causes of local osteolytic hypercalcemia

Breast carcinomas
Myeloma