Path 7 Parathyroid Flashcards Preview

Test 9 > Path 7 Parathyroid > Flashcards

Flashcards in Path 7 Parathyroid Deck (22):
1

Normal parathyroid histo

Chief cells and fat

2

PTH regulation

++ low free Ca
-- high free Ca

3

PTH function (4)

-Increase osteoclast activity
-Increase Vitamin D activation -> small bowel Ca, PO4 reabsorption
-Increase renal Ca reabsorption (distal)
-Increase renal PO4 excretion (proximal)

4

Primary hyperparathyroidism

Hypercalcemia (usually asymptomatic)
-Painful Bones (osteitis fibrosa cystica)
-Renal Stones
-Abdominal Groans (const, ulcer, gall, pancreatitis)
-Psychic Moans

5

Primary hyperparathyroidism lab

-High PTH
-High Ca
-Low PO4
-High urinary cAMP
-High Alkaline Phosphatase

6

Main cause of hyperparathyroidism

Adenoma (95%)

7

Main cause of hyperthyroidism

Graves

8

Parathyroid adenoma mutations

Cyclin D1
MEN1

9

Parathyroid adenoma familial syndromes

MEN-1
MEN-2
Familial hypocalciuric hypercalcemia: (decreased Ca sensitivity)

10

Parathyroid adenoma histo

Packed with uniform polygonal chief cells, involves one gland

11

Primary parathyroid hyperplasia

Looks like adenoma but involves all 4 glands
-Can be associated to MEN

12

Secondary hyperparathyroidism

Caused by chronic hypocalcemia (renal failure)

13

Primary v secondary hyperparathyroidism

High v Low serum Ca

14

Calciphylaxis

Calcification of vessel walls -> ischemic damage to skin & organs

15

Renal osteodystrophy

High PTH levels cause bone resorption

16

Tertiary hyperparathyroidism

Parathyroid becomes autonomous after chronic secondary hyperparathyroidism
-Hypercalcemia
-Tx with parathyroidectomy

17

Congenital hypoparathyroidism

DiGeorge syndrome

18

DiGeorge syndrome

CATCH-22
-Cardiac abnormality (fallot)
-Abnormal facies
-Thymic aplasia
-Cleft palate
-HypoT/HypoPT (aplasia)
-chromosome 22q11

19

Hypoparathyroidism (hypocalcemia) clinical (4)

-Long QT interval
-Calcifications of basal ganglia and lens
-Mental status changes
-Muscle tetany/spasms

20

Hypocalcemia clinical signs

Chvostek sign: facial nerve tapping -> contraction
Trousseau sign: Blood pressure cuff -> carpal spasms

21

Pseudohypoparathyroidism

End-organ resistance to PTH
-Short 4th, 5th digits
-May show resistance to TSH, FSH/LH as well

22

Pseudohypoparathyroidism labs

-Normal or high PTH
-Low serum Ca
-High serum PO4