Parathyroid diseases Flashcards

1
Q

What is the function of the parathyroid?

A

Secrete parathyroid hormone

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2
Q

What does low calcium do?

A

-Increase PTH

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3
Q

What regulates PTH release?

A

-Free calcium in the blood

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4
Q

What does PTH activate?

A

-Osteoclasts and bone resorption to increase serum calcium

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5
Q

What can excessive release of PTH cause?

A

-Osteoporosis

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6
Q

Besides osteoclasts and bone resorption what else does PTH do?

A
  • Activate Vitamin D
  • Increase GI absorption
  • Increase tubular reabsorption of calcium
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7
Q

What can cause hypercalcemia?

A
  • Tumor

- Primary hyperparathyroidism

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8
Q

What is secondary hyperparathyroidism?

A

-Intestinal malabsorption of vitamin D or calcium

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9
Q

Primary hyperparathyroidisms are mostly what?

A

Adenomas

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10
Q

What are the symptoms of primary hyperparathyroidism?

A

-Osteoporosis (Fractures)
-Increased systemic levels of calcium causing constipation
-nonspecific weakness
-anorexia
-Stones
-Peptic ulcers
-Depression
-Cystic bone lesions
“Bones, stones, groans, and moans”

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11
Q

What heart condition can be associated with primary hyperparathyroidism?

A

-Arrhthmias

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12
Q

What lab findings do you see with primary hyperparathyroidism?

A

-Elevated serum Ca++
-Hypophosphatemic
(Remember Ca++ and phosphates often go in opposite directions)
-High or normal PTH

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13
Q

What is Denosumab (XGEVA)?

A
  • Treatment for osteoporosis
  • Antibody to the osteoclastic-stimulationg protein (RANK)
  • Ultimately blocks osteoclast number and activity
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14
Q

What is Teraparatide (Forteo)?

A
  • Treatment for osteoporosis

- A recombinant form of parathormone segment which selectively activates osteoblasts and stimulates new bone formation

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15
Q

What do estrogens or estrogen modulators do for osteoporosis?

A

-Prevent bone loss early in postmenopausal period

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16
Q

What should estrogens be used in combination with in postmenopausal women?

A

-Progestin to protect against venous thrombi

17
Q

What are bisphosphonates used to treat osteoporosis?

A
  • Ibandronate (Boniva)

- Alendronate (Fosamax)

18
Q

What do bisphosphonates do?

A
  • Suppress activity of osteoclasts and inhibit bone resorption
  • Interferes with maxilla and mandible boney repair after surgery leading to bone necrosis
19
Q

What drug if used chronically can cause osteoporosis?

A

-Glucocorticoids

20
Q

What do glucocorticoids do?

A
  • Antagonize vit. D- stimulated intestinal Ca++ tranport and stimulates renal secretion
  • Blocks osteoblastic function
21
Q

What is Hypoparathyroidism cause by?

A

-It is rare and most often caused from accidental removal at thyroid surgery

22
Q

What are the symptoms of Hypoparathyroidism?

A
  • Hypocalcemia
  • Decreased PTH
  • Tetany
  • Dental changes in children
23
Q

What is Calcitonin?

A
  • Action opposite of PTH
  • Inhibits osteoclastic activity
  • Used for paget’s disease