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128 - Gen Endocrine > The Parathyroid Gland > Flashcards

Flashcards in The Parathyroid Gland Deck (17):
1

Draw the overview of the Parathyroid and Calcium System

A image thumb
2

What is the pathway of Vitamin D activation?

1) By the skin to D3

2) By the liver to 25 hydroxyvitamin D

3) By the kidney to 1,25 dehydroxyvitamin D (Calcitrol). This is controlled by PTH and causes increased calcium uptake

3

What does calcitonin do?

It decreases calcium resorption

 

Low calcium means low calcitonin and low deposition and high absorption

High calcium means high calcitonin and high deposition and low absorption

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4

What are the symptons, investigations and treatment of Primary Hyperparathyroidism.

What is the process?

 

Increased PTH causing increased calicum and calicum blocks transmission

Symptoms  - Stones, moans, groans, thrones psychiatric overtones

Investigations. HIGH PTH, HIGH CALCIUM, HIGH URINE CALCIUM LOW PHOSPHATE

Treatment - Surgery, observation

5

What are the symptoms, investigations and treatment of secondary hyperparathyroidism?

What is the process?

Low calcium causes an increase in PTH

Symptoms  - Stones, moans, groans, thrones psychiatric overtones or NONE

Investigations. HIGH PTH, Normal CALCIUM, HIGH PHOSPHATE

Treatment - Surgery, observation

6

What is the relatioship between calcium and phosphate?

Usually mirror, except in seconday hyperparathyroidism

7

What are the symptoms, investigations and management of tertiary hyperparathyroidism?

What is the process?

Long term low Calcium leads to hight PTH and high calcium. Different to secondary where calcium levels are normal

Symptoms  - Stones, moans, groans, thrones psychiatric overtones

Investigations. HIGH PTH, HIGH CALCIUM, LOW PHOSPHATE

Treatment - Surgery, observation

8

What are the symptoms and investigations of malignant hypercalcemia?

What is the process?

Malignancy causing high calcium levels. This needs to be addressd by treating the malignancy

Symptoms  - Stones, moans, groans, thrones psychiatric overtones and WEIGHT LOSS

Investigations - Low PTH, HIGH Calcium, Low phosphate

 

9

What are the symptoms, investiagations, treatment and pathology of hypoparathyroidism?

 

Symptoms  - Diarrhoea, pins and needles, tinnitus, clonus, Increased bone density.

Investigations - LOW PTH, LOW CALCIUM, HIGH PHOSPHATE, HIGH BONE DENSITY

Treatment - with calcium or vitamin D to increase absorption

Pathology - Underactive parathyroid meaning less calcium in the blood but more in the bones

Calcium limits nerve transmission so without it there are postiive nerve signs

 

This is often associated with surgery

 

 

Investigations - LOW PTH, LOW CALCIUM, HIGH PHOSPHATE, HIGH BONE DENSITY

10

What are the symptoms, investigations, treatment and pathology of pseudohypoparathyroidism?

 

 

Symptoms - Should metacarpals and round face - Albrights heriditary dystrophy

Investigations - High PTH, Low Calcium, High phosphate

Pathology - An end organ resistance to PTH so althought it is here there is low calcium, causing symptoms.

Treatment - Vitamin D to try and increase calcium levels

11

What are the symptoms, investigations, management and pathology of hypomagneasimia?

 

Symptoms -  Tinnitus, diarrhoea, clonus, pins and needles

Investigations - Low calcium, low PTH and low magnesium

Pathology - Magnesium is needed for PTH

Treatment - Magnesium

12

What are the symptoms, investigations and treatment of hypervitamindosis and what is it associated with?

 

 

Symptoms - Stones, moans, groans, bones, psychiatric overtones

Investigations - High Vit D, high Calcium, Low PTH

Treament - Stop diet, steroids for sarcoidosis

 

Pathology - Associated with diet, or SARCOIDOSIS

Too much VIt D causes increased Calcium and associated symptoms

13

Where is calcitonin released from?

Parafollicular cells of Thyroid

14

What is a key sign of hypoparathyroidism and what is hypoparathyroidism often associated with?

Increased bone density

Surgery

15

What differentiates primary and tertiary hyperparathyroidism?

PTH is much higher in tertiary

16

What condition is associated with renal failure?

secondary hyperparathyroidism

17

When enzyme does PTH upregulate in the kidney?

1 alpha hydroxylase