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Flashcards in parathyroid disease Deck (26)
1

the inferior parathyroid glands arise from the ___and superior from the ___ branchial pouches

3rd; 4th

2

types of iPTH assays (2)

1. IRMA - 2 site assay
2. ICMA - 2 site assay

3

what are IRMA and ICMA specific to?

intact PTH

4

target organs of PTH (3)

1. bone
2. intestinal mucosa
3. kidney

5

where does most Ca absorption happen?

proximal tubule

6

where does PTH fine tune Ca absorption?

distal tubule

7

what acid-base balance would you expect in a hyperPTH person?

hyperchloremic metabolic acidosis

8

if a patient is hypercalcemic, 1st test to check is?

PTH

9

most common cause of primary hyper parathyroidism

single parathyroid adenoma

10

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

11

what type of bone suffers greater loss of Ca in hyper PTH?

cortical bone (wrist, phalanges, skull)

12

what is the cure for primary hyper PTH?

surgery

13

acute hypocalcemia 48 hours after removal of parathyroids is due to?

hungry bones syndrome

14

vitamin D deficiency or renal failure leads to what type of hyperparathyroidism?

secondary hyperparathyroidism

15

continuous hyperparathyroidism resulting from chronic renal disease?

tertiary

16

inactivating mutation in CaR with mild hypercalcemia, normal/elevated iPTH, LOW URINE Ca, asymptomatic

Familial Hypocalciuric Hypercalcemia(FHH)

17

what differentiates FHH from primary hyperparathyroidism?

urine Ca

18

surgery recommended for those with serum Ca ____, creatinine clearance___, age___

1 mg/dl upper limits of normal; under 75%; under 50 years

19

causes of hypo PTH

1. decr PTH production
2. resistance to PTH

20

if patient hypocalcemic, high PTH, causes include (2)

1. Vit D deficiency
2. pseudo hypoPTH

21

tx of hypocalcemia (3)

1. IV Ca gluconate
2. Vit D3
3. synthetic PTH analog (NATPARA)

22

defect in Gs subunit of PTH receptor on end organ

pseudohypoparathyroidism

23

pseudohypoparathyroidism has ____Ca, ____P, ____iPTH

low Ca, high P, high iPTH

24

pseudohypoparathyroidism with short stature, round face, short metacarpals/metatarsals, calcified basal ganglia, and abnormal lab findings

Type 1A Albright's hereditary osteodystrophy

25

pseudohypoparathyroidism with lab findings, not not phenotype

pseudohypoparathyroidism type 1B

26

pseudohypoparathyroidism with short stature, round face, short metacarpals/metatarsals, calcified basal ganglia, BUT no abnormal lab findings

pseudo pseudohypoparathyroidism