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Parathyroid Flashcards

(53 cards)

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1
Q

What week do the branchial arches and pharyngeal pouches form?

A

4th week

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2
Q

From which pharyngeal pouch do the superior parathyroids develop?

A

4th pharyngeal pouch

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3
Q

What is the normal position of the superior parathyroid glands by the 5th week?

A

Caudally and medially

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4
Q

Which pharyngeal pouch is associated with the inferior parathyroids?

A

3rd pharyngeal pouch

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5
Q

What is the standard size of a parathyroid gland?

A

4 mm in diameter

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6
Q

What is the combined weight of the parathyroid glands?

A

About 120 mg

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7
Q

What is the most common location for ectopic parathyroid tissue?

A

Esophagus, mediastinum, intrathyroid

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8
Q

What syndrome is characterized by congenital aplasia of the thymus and parathyroid glands?

A

DiGeorge syndrome

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9
Q

What type of cells are primarily found in the parathyroid glands?

A

Chief cells

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10
Q

What hormone do parathyroid glands secrete?

A

PTH (parathormone)

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11
Q

What is the arterial supply for the inferior parathyroid gland?

A

Inferior thyroid artery

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12
Q

What condition is characterized by increased production of PTH due to normal feedback disturbance?

A

Primary Hyperparathyroidism

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13
Q

What is the estimated incidence of primary hyperparathyroidism in women?

A

2-3 cases per 1000 women

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14
Q

What percentage of primary hyperparathyroidism cases are caused by a solitary parathyroid adenoma?

A

> 80%

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15
Q

What are the three histological patterns seen in primary hyperparathyroidism?

A
  • Single Adenoma * Hyperplasia * Carcinoma
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16
Q

What is the most common cause of symptomatic hypercalcemia?

A

Malignancy

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17
Q

List three clinical features associated with symptomatic hypercalcemia.

A
  • Kidney issues (polyuria, renal stones) * GIT problems (constipation, pancreatitis) * CNS effects (weakness, depression)
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18
Q

What is the most common renal complication associated with hyperparathyroidism?

A

Nephrolithiasis

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19
Q

What is the typical laboratory finding in hyperparathyroidism?

A

Elevated Serum Ca and PTH

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20
Q

Fill in the blank: Elevated _______ phosphatase can be seen in 10-40% of hyperparathyroidism cases.

A

Alkaline

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21
Q

What imaging technique is most sensitive for localizing adenomas in primary hyperparathyroidism?

A

Sestamibi scan

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22
Q

What is the primary treatment for hyperparathyroidism?

23
Q

What is the common treatment for hypocalcemia post-parathyroid surgery?

Study These Flashcards
A

Oral calcium carbonate or IV calcium gluconate

24
Q

What condition leads to secondary hyperparathyroidism due to hypocalcemia?

Study These Flashcards
A

Chronic renal failure

25
What is the rare cause of hyperparathyroidism characterized by ectopic production of PTH-like hormone?
Paraneoplastic syndrome
26
What percentage of primary hyperparathyroidism cases are due to parathyroid carcinoma?
< 5%
27
What is the typical age range for patients diagnosed with parathyroid carcinoma?
40-50 years
28
What is the sensitivity range for high-resolution ultrasound in detecting adenomas?
65-85%
29
What is the surgical indication for asymptomatic patients with primary hyperparathyroidism?
Persistent calcium elevation above normal
30
What is the common complication of hypercalcemia that can affect the kidneys?
Renal failure
31
What are the symptoms of a hypercalcemic crisis?
* Anorexia * Nausea * Vomiting * Polyuria * Abdominal pain
32
What is the recommended initial treatment for a hypercalcemic crisis?
Rapid rehydration with normal saline
33
What is Mithramycin used for?
May be used as a last resort ## Footnote Improper use can lead to aplastic anemia (25 microgram/kg over 4 hours IVPB)
34
What treatment can lower serum calcium emergently?
Dialysis
35
What condition does Secondary Hyperparathyroidism occur secondary to?
Hypocalcemia
36
What are the common causes of Secondary Hyperparathyroidism?
* Chronic renal failure * Vitamin D deficiency * Peripheral resistance to PTH (pseudo-hypoparathyroidism)
37
What is observed in resected glands from secondary HPT?
Diffuse and nodular hyperplasia
38
What is a diagnostic indicator of elevated PTH?
Elevated PTH in the setting of low serum calcium levels
39
What is a common underlying condition for secondary hyperparathyroidism?
Chronic renal failure
40
Name two other conditions that can cause secondary hyperparathyroidism.
* Osteogenesis imperfecta * Paget’s disease * Multiple myeloma
41
What is the pathophysiology in renal failure associated with secondary hyperparathyroidism?
* Increased phosphate * Decreased serum calcium * Decreased gut absorption of calcium due to decreased renal 1-hydroxylation of vitamin D2 * Decreased renal clearance of PTH breakdown products
42
What is the morphology of secondary hyperparathyroidism?
Similar to primary hyperplasia (all four glands involved)
43
What do X-rays reveal in patients with secondary hyperparathyroidism?
Osteoclastic bone lesions (renal osteodystrophy)
44
List some clinical manifestations of secondary hyperparathyroidism.
* Psychiatric disorders * Headache * Muscle weakness * Weight loss * Fatigue * Renal osteodystrophy * Soft tissue calcifications
45
What are the laboratory findings in secondary hyperparathyroidism?
* High PTH * Normal or low calcium * High phosphate * High alkaline phosphatase
46
What is the treatment for secondary hyperparathyroidism?
* Phosphate-binding antacids * Oral calcium and vitamin D * Increased calcium dialysate for chronic renal insufficiency patients
47
What surgical options are available for uncontrolled symptoms of secondary hyperparathyroidism?
* 3½-gland parathyroidectomy * 4-gland parathyroidectomy with implantation of minced glands
48
What defines Tertiary Hyperparathyroidism?
Persistent hyperparathyroidism and hypercalcemia following successful renal transplant or resolution of underlying disorder
49
What percentage of patients may have irreversible pathophysiology after pre-transplant hyperparathyroidism?
Up to 30%
50
What is a characteristic feature of parathyroid glands in Tertiary Hyperparathyroidism?
Parathyroid gland hyperplasia with autonomous PTH production
51
What is the serum profile in Tertiary Hyperparathyroidism?
* High PTH * Normal or high calcium * Low phosphate * High alkaline phosphatase
52
When is surgery indicated for Tertiary Hyperparathyroidism?
For symptomatic patients or unresponsive to medical management 6 months post-transplant
53
What surgical procedure is performed for Tertiary Hyperparathyroidism?
3½-gland parathyroidectomy with implantation of minced glands into muscle

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