Flashcards in parathyroid disease Deck (26)
the inferior parathyroid glands arise from the ___and superior from the ___ branchial pouches
types of iPTH assays (2)
1. IRMA - 2 site assay
2. ICMA - 2 site assay
what are IRMA and ICMA specific to?
target organs of PTH (3)
2. intestinal mucosa
where does most Ca absorption happen?
where does PTH fine tune Ca absorption?
what acid-base balance would you expect in a hyperPTH person?
hyperchloremic metabolic acidosis
if a patient is hypercalcemic, 1st test to check is?
most common cause of primary hyper parathyroidism
single parathyroid adenoma
primary hyperPTH results in ____serum Ca, ___serum phosphate, ___iPTH, ____urine Ca
incr serum Ca, decr or normal phosphate, incr or normal iPTH, incr urine Ca
what type of bone suffers greater loss of Ca in hyper PTH?
cortical bone (wrist, phalanges, skull)
what is the cure for primary hyper PTH?
acute hypocalcemia 48 hours after removal of parathyroids is due to?
hungry bones syndrome
vitamin D deficiency or renal failure leads to what type of hyperparathyroidism?
continuous hyperparathyroidism resulting from chronic renal disease?
inactivating mutation in CaR with mild hypercalcemia, normal/elevated iPTH, LOW URINE Ca, asymptomatic
Familial Hypocalciuric Hypercalcemia(FHH)
what differentiates FHH from primary hyperparathyroidism?
surgery recommended for those with serum Ca ____, creatinine clearance___, age___
1 mg/dl upper limits of normal; under 75%; under 50 years
causes of hypo PTH
1. decr PTH production
2. resistance to PTH
if patient hypocalcemic, high PTH, causes include (2)
1. Vit D deficiency
2. pseudo hypoPTH
tx of hypocalcemia (3)
1. IV Ca gluconate
2. Vit D3
3. synthetic PTH analog (NATPARA)
defect in Gs subunit of PTH receptor on end organ
pseudohypoparathyroidism has ____Ca, ____P, ____iPTH
low Ca, high P, high iPTH
pseudohypoparathyroidism with short stature, round face, short metacarpals/metatarsals, calcified basal ganglia, and abnormal lab findings
Type 1A Albright's hereditary osteodystrophy
pseudohypoparathyroidism with lab findings, not not phenotype
pseudohypoparathyroidism type 1B