Lecture 5 - Parathyroid/calcium disorders Flashcards Preview

ICM - Endocrine > Lecture 5 - Parathyroid/calcium disorders > Flashcards

Flashcards in Lecture 5 - Parathyroid/calcium disorders Deck (32):
1

PTH is released in response to low serum ____ or high serum ____

calcium, phosphate

2

PTH:
increases reabs of calcium in the _____;
increases secretion of phosphate in the _____;
increases production of Vit D by stimulating ____ in the _____;
increases bone resorption of ....

DCT;
PCT;
1 alpha hydroxylase, PCT;
Ca and PO4

3

calcitriol causes increased release of ____ which decreases bone formation.
calcitriol also increases calcium and phosphate reabsorption from the ____ and _____

FGF23;
GI, kidney

4

calcium:
increase in concentration causes a _____ in refractoriness of stimulation of neurons and muscle cells

increase

causing coma, muscular weakness

5

decrease in calcium leads to _____ in neuromuscular excitability-->translates into _____ and ____

increase;
tetany, convulsions

6

what is the name of the calcium salt that is the major structural cation?

hydroxyapatite

7

calcium:
alkalosis causes a _____ in binding affinity to albumin, ____ calcium levels and causing _____

increase;
lowering;
tetany, parasthesia

8

calcium levels also decrease with decreased levels of serum ____ or increased levels of ____

albumin, phosphate

9

hypocalcemia:
____;
chvostek sign =
trousseau sign =
in the heart: ______

tetany;
tap facial nerve-->contract muscle;
occlude brachial artery-->carpal spasm;
prolonged QT (risk of torsades)

10

hypoparathyroidism: during ____ surgery, autoimmune destruction, ____ syndrome

thyroid;
digeorge

11

digeorge syndrome:
CATCH 22

C = cleft palate
A = abnormal facies
T = thymic aplasia --> T cell deficiency
C = cardiac defects
H = hypo calcemia

22q11 deletion

12

according to FA, normal serum calcium is between ____ and ____

8.4-10.2 mg/dL

13

hypercalcemia symtpoms:
_____, ____, _____, _____, and ____ overtones

stones (nephrolithiaisis)
bones (bone pain)
groans (abdominal pain, constipation)
thrones (increased urinary frequency)
psychiatric (anxiety, impaired concentration)

14

primary hyperparathyroidism:
usually due to ___ or ____;
in addition to the hypercalcemia symptoms mentioned, can have acute ____, ______ ulcers, nephrocalcinosis

adenoma, hyperplasia;
pancreatitis;
peptic

15

familial hypocalciuric hypercalcemia:
due to defective ______ in multiple tissues. ____ than normal Calcium is required to suppress PTH =
mild ____ and hypo _____ with ____ PTH levels

Ca sensing receptors;
greater;
hypercalcemia, hypocalcuria;
normal to increased

16

diuretics:
_____ diuretics decrease reabsorption --> hypocalcemia;
_____ diuretics increase reabsorption

loop;
thiazide

17

hypercalcemia of malignancy can be due to ____ or _____

bony metastases;
PTHrp

18

after confirming clinical hypercalcemia, what should you check next?

intact PTH
( if increased, primary HPTH or familial)

19

with chronic renal failure:
___calcemia, ____phosphatemia, failure of _____ --> __ PTH levels

hypo, hyper;
vitamin D hydroxylation;
increased

20

criteria for surgery of primary hyperPTH:
clinical manifestations of __.
age ___ than 50 years;
creastinine clearance less than ____
current or past kidney ___

hypercalcemia;
less than;
60;
stones

21

Vitamin D deficiency causes a ____ in urinary phosphate excretion

increase

22

symptoms of hypophosphatemia:
bone ____, ____ levels fall causing an increase in Hb affinity = tissue ____;
encepalopathy, rhabdomyolysis

loss;
2,3 DPG;
hypoxia

23

hyperphosphatemia:
renal ____, metastatic _____, ___calcemia

asociated with tumor lysis, rhabdomyolysis
hypo PTH

stones, calcification, hypo

24

osteomalacia:
decreased VIT D --> ____ serum Ca --> ___ PTH --> ____ serum PO4

____ ALP

decreased, increased, decreased;

increased

25

rickets symptoms:
genu ____ (bow legs),
bead-like _______ (rachitic rosary),
_____ (Soft skull),
frontal bossing

varum;
costochondral junction;
craniotabes

26

_____ are characteristic radiological findings in osteomalacia. they are ____ of femoral neck/nearby areas

looser's zones;
pseudofractures

27

chronic kidney disease:
see ____ Ca absorption and/or ____ phosphate absorption . renal failure causes decreased ____ levels --> excessive levels of _____

decreased, increased;
vitamin D;
PTH (secondary HPTH)

28

______ is due to high bone turnover caused by hypert PTH. causes ____ bone spaces

osteitis fibrosa cystica;
cystic

29

what is tertiary hyper PTH?

autonomous/refractory hyper PTH resulting from CKD.

30

3 stages of paget disease:

osteoclastic overactivation (lytic)
mixed osteoblasts and osteoclasts
osteoblast overactivation (sclerotic)

31

paget's:
localized or widespread bone disorder?
associated with increased _____ size.
____ loss from foramen narrowing.
____ ALP

localized;
hat;
hearing;
increased

32

serum Vit D levels should be greater than ___ ng/mL

32