parathyroid

Question 1

What is the parathyroid gland

Answer 1

4 pea sized gland located on the posterior surface of the thyroid

Question 2

What is the job of the parathyroid gland

Answer 2

parathyroid hormone (PTH) secretion for the regulation of serum calcium levels (direct correlation)

Question 3

What are the severel targets PTH can act on to alter serum calcium levels

Answer 3

bones
kidneys
GI tract

Question 4

What vitamin is necessary for calcium homeostasis and absorption

Answer 4

Vitamin D

Question 5

Where is Vitamin D activated

Answer 5

kidneys, stimulated by PTH

Question 6

What is the function of calcitonin

Answer 6

functions to lower serum calcium

Question 7

Where is calcitonin secreted from

Answer 7

by the thyroid in response to elevated serum calcium

Question 8

What is hyperparathyroidism

Answer 8

overactive parathyroid
*can be primary or secondary

Question 9

What is primary hyperparathyroidism

Answer 9

problem is the parathyroid themselves
*generally from a parathyroid adenoma

Question 10

What is secondary hyperparathyroidism

Answer 10

problem outside of the parathyroid
*hyperphosphatemia, renal failure, malabsorption of vitamin D

Question 11

What is the most common cause of primary hyperparathyroidism

Answer 11

Hypercalcemia

Question 12

What are the causes of primary hyperparathyroidism

Answer 12

1 single gland adenoma
hyperplasia
multiple adenoma
carcinoma

Question 13

Which gender is at higher risk for hyperparathyroidism

Answer 13

women (60-70y/o)
*african american

Question 14

IF symptoms present with primary hyperparathyroidism, what are they

Answer 14

Bones (joint pain)
stones (kidney stones)
abdominal groans (N/V)
psychic moans (depression)
fatigue overtones

Question 15

If calcium >14 or PTH>5x normal, what should be considered

Answer 15

cancer

Question 16

What is the first lab that should be drawn when working up hyperparathyroidism

Answer 16

serum calcium

Question 17

How can you confirm hyperparathyroidism

Answer 17

urinary calcium

*genetic testing <40y/o

Question 18

What is the mainstay treatment of hyperparathyroidism

Answer 18

parathyroidectomy

Question 19

What is the surgical criteria for primary hyperparathyroidism

Answer 19

calcium >11.5
DXA <-2.5
+ kidney stones
+ hx fragility fx
age< 50

Question 20

What is a concern for people post op with hyperparathyroidism

Answer 20

transient hypocalcemia

Question 21

what is the only direct pharmacotherapeutic option for hypercalcemia

Answer 21

Cincalcet

Question 22

What osteoporosis medications can be given with primary hyperparathyroidism

Answer 22

bisphosphonates

Question 23

How do you treat secondary hyperparathyroidism

Answer 23

treat underlying cause
-increase calcium
-decrease phosphorus
-increase vitamin D
- HD if CKD present

Question 24

What is the number one cause of hypoparathyroidism

Answer 24

parathyroid damage during surgery

Question 25

What are some symptoms of hypoparathyroidism

Answer 25

paresthesias
tetany
seizures
arrhythmias
SOB/Stridor

Question 26

What are characteristics of hypoparathyroidism seen on PE

Answer 26

Chovsteks sign
Trousseaus sign
hyperreflexia

Question 27

What is chovsteks sign

Answer 27

tap on facial nerve = ipsilateral grimace

Question 28

What is trousseaus sign

Answer 28

involuntary movement of wrist/hand with BP cuff inflation

Question 29

What are those with hypoparathyroidism at an increased risk for

Answer 29

cataracts

Question 30

What is the mainstay treatment for hypoparathyroidism

Answer 30

calcium + activated Vitamin D supp