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Zak, Endo/Repro 2 > Parathyroid Pathology > Flashcards

Parathyroid Pathology Flashcards

1
Q

What are the two cell types that make up the parathyroid?

A

Chief cells

Oxyphill cells

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2
Q

What hormone do Chief cells secrete?

A

PTH

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3
Q

What makes Oxyphill cells pink?

A

Abundance of mitochondria

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4
Q

What are the main functions of PTH?

A

Increase renal resorption of Ca
Increase urinary PO4 excretion
Increase conversion of Vitamin D –> Dihydroxy form
Release Ca and PO4 from bone

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5
Q

What is the most common cause of Primary Hyperparathyroidism?

A

Parathyroid Adenoma

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6
Q

What is the most common cause of asymptomatic hypercalcemia?

A

Parathyroid Adenoma

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7
Q

What molecular defects are found in sporadic Parathyroid Adenomas?

A

Cyclin D1

MEN1

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8
Q

What molecular defects are found in familial Parathyroid Adenomas?

A

MEN1

RET

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9
Q

How many glands does Parathyroid Adenoma typically affect?

A

1 of the 4

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10
Q

Morphology = well-circumscribed, hypercellular (mostly Chief) mass in a single parathyroid gland

A

Parathyroid Adenoma

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11
Q

What disease causes all 4 glands of the parathyroid to be enlarged, even if they are asymmetrically enlarged?

A

Parathyroid Hyperplasia

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12
Q

What do the cells of Parathyroid Carcinoma look like?

A

Normal parathyroid gland cells

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13
Q

How is the Dx of Parathyroid Carcinoma made?

A

By the presence of invasion or metastases

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14
Q

What are the Sx’s of Primary Hyperparathyroidism?

A

Bones, Stones, Groans (GI), and Moans (Psych)

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15
Q

What is the MOA for Secondary Hyperparathyroidism?

A

Compensatory hypersecretion of PTH due to prolonged hypocalcemia

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16
Q

What are some EX’s of Secondary Hyperparathyroidism?

A

Chronic renal failure
Poor dietary Ca intake
Steatorrhea
Vitamin D deficiency

17
Q

Morphology = Hyperplastic parathyroid gland with metastatic calcifications seen in lungs, heart, stomach, and blood vessels

A

Secondary Hyperparathyroidism

18
Q

What is Calciphylaxis?

A

Vascular calcification –> ischemic damage to the skin and other organs

19
Q

What is the MOA of Tertiary Hyperparathyroidism?

A

Hypersecretion of PTH after the cause of the prolonged hypocalcemia (2˚ Hyperparathyroidism) has been corrected

20
Q

What is the Tx for Tertiary Hyperparathyroidism?

A

Surgical removal (leave a little for normal physiologic function)

21
Q

What is the Tx for Secondary Hyperparathyroidism?

A

Vitamin D supplements

PO4 binders

22
Q

What type of inheritance pattern does Familial Hypocalciuric Hypercalcemia have and what is the mutated gene?

A

AD

Calcium-Sensing Receptor gene (CASR)

23
Q

What are some causes of hypoparathyroidism?

A 
Hypercalcemia of malignancy
Vitamin D toxicity
Immobilization
Thiazide diuretics
Granulomatous disease (Sarcoidosis)
24
Q

What are Brown Tumors?

A

Microfractures in bone –> secondary hemorrhage –> influx of macrophages and repair with fibrous tissue –> formation of a mass

25
Q

What is Osteitis Fibrosa Cystica?

A

Increased osteoclast activity, peritrabecular fibrosis, and cystic brown tumors

26
Q

What is Nephrocalcinosis?

A

Calcification of renal interstitium and tubules

27
Q

What is the most common cause of symptomatic hypercalcemia

A

Hypercalcemia of malignancy

28
Q

The most common types of tumors causing Hypercalcemia of Malignancy are located where?

A

Lung
Breast
Head/Neck
Kidneys

29
Q

What hormone typically causes the hypercalcemia in Hypercalcemia of Malignancy?

A

PTH-Related Peptide (PTHrP)

30
Q

What are the main 4 lab values used to Dx Hypercalcemia of Malignancy?

A

Hypercalcemia
Elevated PTH
Hypophosphatemia

31
Q

What is the most common cause of hypoparathyroidism?

A

Surgically induced

32
Q

What autoimmune issues are associated with hypoparathyroidism?

A

Chronic mucocutaneous candidiasis

Primary Adrenal Insufficiency (AKA Autoimmune Polyendocrine Syndrome Type-1 [APS1])

33
Q

What mutation is associated with the inherited form of hypoparathyroidism and what type of inheritance pattern does it follow?

A

GofF of CASR gene

AD

34
Q

Sx’s = tetany, mental status change, prolonged QT interval, dental abnormalities in kids

A

Hypoparathyroidism (hypocalcemia)

35
Q

What disease causes congenital absence of the parathyroid glands?

A

DiGeorge syndrome

36
Q

What disease is due to end-organ resistance to PTH?

A

Pseudohypoparathyroidism

37
Q

What would the lab values be for Ca and PO4 in Pseudohypoparathyroidism?

A

Hypocalcemia

Hyperphosphatemia

38
Q

What would the lab values be for PTH in Pseudohypoparathyroidism?

A

Normal or elevated PTH

39
Q

In pts with Pseudohypoparathyroidism, which other hormones might the pts have end-organ resistance to?

A

TSH

FSH/LH

Zak, Endo/Repro 2 (33 decks)

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