Normal and Abnormal Parathyroid

Question 1

What cells are the primary source of production of PTH?

Answer 1

Chief cells

Question 2

What does PTH regulate?

Answer 2

1. Blood Calcium
2. Phosphorous levels

Question 3

What happens to PTH when blood calcium levels rise?

Answer 3

PTH decreases

Question 4

What does PTH do?

Answer 4

Increases blood calcium

Question 5

what organs does PTH target?

Answer 5

1. Kidneys
2. Intestines
3. Bones

Question 6

What vitamin is activated by the kidneys resorption of PTH?

Answer 6

Vitamin D

Question 7

What is the most common ectopic location for the inferior parathyroid gland?

Answer 7

Anterior mediastinum

Question 8

What does the thymus gland release?

Answer 8

Thymosin

Question 9

What is the role of the thymus?

Answer 9

Immune function

Question 10

When is the thymus the largest in humans?

Answer 10

Peds and children

Question 11

What slowly replaces the thymus gland after puberty?

Answer 11

FAT

Question 12

What lab tests may be given to assess parathyroid function?

Answer 12

1. PTH levels
2. Blood calcium

Question 13

Target organs for PTH?

Answer 13

1. Bone
2. Kidneys
3. Intestines

Question 14

What may cause elevated PTH?

Answer 14

1. Vitamin D deficiency
2. Chronic renal failure
3. Hyperparathyroidism

Question 15

What may cause a decrease in PTH?

Answer 15

1. Metastatic bone tumours
2. Autoimmune
3. Congenital absence
4. Hypoparathyroidism

Question 16

What are the most common causes of hypercalcemia?

Answer 16

1. Hyperparathyroidism
2. Excess vitamin D
3. Calcium resorption with bone METS

Question 17

What is the most common cause of hypocalcemia?

Answer 17

Hypoparathyroidism

Question 18

Symptoms of hypercalcemia?

Answer 18

1. Weight loss
2. Anorexia
3. Digestive issues
4. Pancreatitis

Question 19

Symptoms of hypocalcemia

Answer 19

1. Irritability
2. Fatigue
3. Anxiety
4. Seizures
5. Psychosis
6. Muscle spasms

Question 20

What are the most common and 2nd most common pathologies seen with primary hyperparathyroidism?

Answer 20

1st = Parathyroid adenoma
2nd = parathyroid hyperplasia

Question 21

What lab values will be increased with primary hyperparathyroidism?

Answer 21

Calcium
PTH

Question 22

Symptoms of primary hyperparathyroidism?

Answer 22

Painful bones
Renal stones
Abdominal groans
Psychic moans

Question 23

What is the most common cause of primary hyperparathyroidism?

Answer 23

Parathyroid Adenoma

Question 24

SF of parathyroid adenoma?

Answer 24

1. Solid
2. Homogenous
3. Hypoechoic
4. Hypervascular or vascular arc
5. Oval shaped

Question 25

Difference between primary and secondary hyperparathyroidism?

Answer 25

Primary involves one of the four glands whereas secondary involves the whole gland

Question 26

What is parathyroid hyperplasia?

Answer 26

Enlargement involving all of the glands

Question 27

Parathyroid hyperplasia may be associated with what?

Answer 27

MEN syndrome (multiple endocrine neoplasia)

Question 28

How to determine between hyperplasia and an adenoma?

Answer 28

Adenoma = solitary Hyperplasia = multiple nodules

Question 29

Is a parathyroid carcinoma functioning or non-functioning?

Answer 29

Functioning

Question 30

SF of parathyroid carcinomas?

Answer 30

1. Lobular 2. Internal cystic components 3. Heterogenous 4. Vascular 5. Usually measures >2cm

Question 31

Will vitamin D deficiency cause an increase or decrease in parathyroid hormone production?

Answer 31

Increased PTH

Question 32

Sarcoidosis occurs in the presence of what abnormality?

Answer 32

Hypercalcemia