Parathyroid gland and calcium

Question 1

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

Answer 1

bones

Question 2

which gland does calcium work on

which receptor

Answer 2

parathyroid gland

calcium sensing receptor (CaSR)

Question 3

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

Answer 3

decreased PTH

Question 4

what is PTH in low calcium

Answer 4

high

Question 5

what is PTH in high calcium

Answer 5

low

Question 6

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

what is the final effect on serum Ca

Answer 6

decreased osteoclasts

decreased blood Ca

Question 7

where is calcitonin made/released from

Answer 7

parafollicular C cells

Question 8

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

what is the final effect on serum Ca

Answer 8

increased (want to chew up bone to release Ca)

increased blood Ca

Question 9

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

Answer 9

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

phosphate excretion

Question 10

main cause of hypercalcaemia

Answer 10

hyperparathyroidism

Question 11

aetiology of hypercalcaemia (4)

not including examples of h….parathyroidism

Answer 11

hyperparathyroidism
lung mets
familial hypocalciuric hypercalcaemia (FHH)
pagets

Question 12

how does hyperparathyroidism cause hypercalcaemia

Answer 12

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

Question 13

what can hypercalcaemia cause in the kidneys

Answer 13

kidney stones

Question 14

how does hypercalcaemia present in the bones (3)

Answer 14

osteoporosis
fractures
bone pain

Question 15

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

Answer 15

hypercalcaemia

Question 16

how does hypercalcaemia affect the brain

Answer 16

confusion

Question 17

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

Answer 17

thirst

polyuria

Question 18

phosphate levels in hyperparathyroid hypercalcaemia

phosphate levels in bone pathology hypercalcaemia

Answer 18

low

high

Question 19

treatment of hypercalcaemia (1 symptomatic and 1 curative)

Answer 19

symptomatic: fluids - bc theyre dehydrated
curative: bisphosphonates

Question 20

aetiology of hypocalcaemia ()

not including examples of h…parathyroidism

Answer 20

vit D deficiency
chronic kidney disease (CKD)
hypoparathyroidism

Question 21

how does CKD (chronic kidney disease) cause hypocalcaemia

Answer 21

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)

Question 22

aetiology of hypoparathyroidism (5)

Answer 22

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

Question 23

aetiology of hyperparathyroidism (4)

Answer 23

parathyroid adenoma
MEN1
MEN2a
MEN2b

Question 24

low levels of which element can cause hypoparathyroidism = hypocalcaemia

Answer 24

low Mg

Question 25

what is pseudohypoparathyroidism caused by pathophysiology

Answer 25

genetics PTH resistance = low Ca

Question 26

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

Answer 26

4th metacarpal bradydactyly (shortening) ha j ur fucked

Question 27

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

Answer 27

PTH high Ca low phosphate high

Question 28

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

Answer 28

PTH high Ca normal phosphate high

Question 29

which congenital issue presents with no parathyroid gland

Answer 29

DiGeorge syndrome

Question 30

hypocalcaemia 4th metacarpal bradydactyly high PTH high phosphate

Answer 30

pseudohypoparathyroidism

Question 31

normal Ca high PTH high phosphate

Answer 31

pseudopseudohypoparathyroidism

Question 32

how does vitamin D deficiency (Causing hypocalcaemia) present; in adults in kids what does this look like

Answer 32

osteomalacia - in adults rickets - in kids 'bendy limbs' waddling gait

Question 33

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

Answer 33

healthy start vitamins

Question 34

how does hypocalcaemia present on ECG

Answer 34

QT prolongation

Question 35

how does hypocalcaemia present in muscles

Answer 35

weakness, cramps

Question 36

what is chovsteks sign what is it used for

Answer 36

taping over facial nerve = face twitches hypocalcaemia

Question 37

what is trousseau sign what is it used for

Answer 37

spasm of muscle in hand/wrist with bp cuff on hypocalcaemia

Question 38

PTH, Ca, phosphate in hypocalcaemia

Answer 38

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

Question 39

treatment of hypocalcaemia acutely

Answer 39

IV calcium (calcium gluconate)

Question 40

treatment of hypocalcaemia chronically (2)

Answer 40

calcium supplements | vit D supplements

Question 41

when is PTH high in hypocalcaemia

Answer 41

when not a parathyroid problem (its trying to compensate)