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J Endocrine > Parathyroid gland and calcium > Flashcards

Parathyroid gland and calcium Flashcards

1
Q

where is there a ‘bank’ of calcium that can be released into the blood

A

bones

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2
Q

which gland does calcium work on

which receptor

A

parathyroid gland

calcium sensing receptor (CaSR)

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3
Q

stimulation of CaSR in the parathyroid gland from increased blood calcium results in

A

decreased PTH

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4
Q

what is PTH in low calcium

A

high

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5
Q

what is PTH in high calcium

A

low

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6
Q

high calcium = low PTH = high calcitonin = … (increased/decreased) osteoclast activity

what is the final effect on serum Ca

A

decreased osteoclasts

decreased blood Ca

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7
Q

where is calcitonin made/released from

A

parafollicular C cells

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8
Q

low calcium = high PTH = low calcitonin = …. (increased/decreased) osteoclast activity

what is the final effect on serum Ca

A

increased (want to chew up bone to release Ca)

increased blood Ca

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9
Q

effect of PTH on kidneys (2 - on calcium and phosphate)

A

increased calcium reabsorption (increase blood Ca bc PTH is high when Ca is low)

phosphate excretion

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10
Q

main cause of hypercalcaemia

A

hyperparathyroidism

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11
Q

aetiology of hypercalcaemia (4)

not including examples of h….parathyroidism

A

hyperparathyroidism
lung mets
familial hypocalciuric hypercalcaemia (FHH)
pagets

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12
Q

how does hyperparathyroidism cause hypercalcaemia

A

high PTH = increased osteoclasts = high blood Ca (low bone Ca)

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13
Q

what can hypercalcaemia cause in the kidneys

A

kidney stones

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14
Q

how does hypercalcaemia present in the bones (3)

A

osteoporosis
fractures
bone pain

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15
Q

(renal) stones, (abdo) groans, bones, psychic moans

A

hypercalcaemia

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16
Q

how does hypercalcaemia affect the brain

A

confusion

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17
Q

how do kidney stones present in a patient with hypercalcaemia (2)

A

thirst

polyuria

18
Q

phosphate levels in hyperparathyroid hypercalcaemia

phosphate levels in bone pathology hypercalcaemia

A

low

high

19
Q

treatment of hypercalcaemia (1 symptomatic and 1 curative)

A

symptomatic: fluids - bc theyre dehydrated
curative: bisphosphonates

20
Q

aetiology of hypocalcaemia ()

not including examples of h…parathyroidism

A

vit D deficiency
chronic kidney disease (CKD)
hypoparathyroidism

21
Q

how does CKD (chronic kidney disease) cause hypocalcaemia

A

kidneys normally reabsorb Ca when levels are low, but in kidney disease you just end up peeing it all out (no reabsorption ability) = hypocalcaemia

OR (i think this one is right, but have both in my notes lol)

in CKD = decreases Ca and phosphate excretion = loads of it in the blood = bind together to make calcium phosphate = hypocalcaemia (bc the calcium isnt on its own)

22
Q

aetiology of hypoparathyroidism (5)

A

congenital absence of parathyroid gland (DiGeorge)
autoimmune destruction of parathyroid gland
parathyroid malignancy
pseudohypoparathyroidism
pseudopseudoparahypothyroidism

23
Q

aetiology of hyperparathyroidism (4)

A

parathyroid adenoma
MEN1
MEN2a
MEN2b

24
Q

low levels of which element can cause hypoparathyroidism = hypocalcaemia

A

low Mg

25
Q

what is pseudohypoparathyroidism caused by

pathophysiology

A

genetics

PTH resistance = low Ca

26
Q

buzzword for pseudohypoparathyroidism (u should probs be concerned about this)

A

4th metacarpal bradydactyly (shortening)

ha j ur fucked

27
Q

what are PTH, Ca and phosphate in pseudohypoparaythyroidism (why its called pseudo…)

A

PTH high
Ca low
phosphate high

28
Q

what are PTH, Ca and phosphate in pseudopseudohypoparathyroidism (think pseudo pseudo…)

A

PTH high
Ca normal
phosphate high

29
Q

which congenital issue presents with no parathyroid gland

A

DiGeorge syndrome

30
Q

hypocalcaemia
4th metacarpal bradydactyly
high PTH
high phosphate

A

pseudohypoparathyroidism

31
Q

normal Ca
high PTH
high phosphate

A

pseudopseudohypoparathyroidism

32
Q

how does vitamin D deficiency (Causing hypocalcaemia) present;
in adults
in kids

what does this look like

A

osteomalacia - in adults
rickets - in kids

‘bendy limbs’
waddling gait

33
Q

what do you give in pregnancy to prevent vit D deficiency in new borns

A

healthy start vitamins

34
Q

how does hypocalcaemia present on ECG

A

QT prolongation

35
Q

how does hypocalcaemia present in muscles

A

weakness, cramps

36
Q

what is chovsteks sign

what is it used for

A

taping over facial nerve = face twitches

hypocalcaemia

37
Q

what is trousseau sign

what is it used for

A

spasm of muscle in hand/wrist with bp cuff on

hypocalcaemia

38
Q

PTH, Ca, phosphate in hypocalcaemia

A

PTH low (if parathyroid cause, high if not)
Ca low
phosphate low

39
Q

treatment of hypocalcaemia acutely

A

IV calcium (calcium gluconate)

40
Q

treatment of hypocalcaemia chronically (2)

A

calcium supplements

vit D supplements

41
Q

when is PTH high in hypocalcaemia

A

when not a parathyroid problem (its trying to compensate)

J Endocrine (12 decks)

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