1What are the structures that are adjacent to the superior parathyroid gland?
middle thyroid artery
recurrent laryngeal nerve
2What is the blood supply to the superior parathyroid gland?
inferior and superior thyroid arteries
3What are the structures adjacent to the inferior parathyroid gland?
lower pole of thyroid
4What is the blood supply to the inferior parathyroid glands?
inferior thyroid artery
5What are the 3 types of cells?
chief
clear
oxyphil
6Which type of cell is the main source of PTH?
chief
7which cell type appears after puberty and increases with age?
oxyphil
8Ionized calcium controls cellular functions like?
hormone secretion/actions
muscle contraction
neuromuscular transmission
blood clotting
9With bound calcium will alkalosis increase or decrease binding to albumnin?
increase
10What are the complex calciums?
citrate
phosphate
bicarbonate
11What happens to the kidneys when PTH is secreted?
stimulates reabsorption of calcium and inhibits reabsorption of phosphate
12What stimulates the GI tract to increase calcium reabsorption?
production of 1.25-(OH)2 D
13What are the signs and symptoms of primary hyperparathyroidism?
nephrolithiasis
osteopenia
pathologic fracture
14What lab values would you see with primary hyperparathyroidism?
increased PTH
increased serum calcium
decreased/normal serum phosphate
PTHrP not detectable or normal
vitamin D is normal or elevated
urine calcium is normal or increased
15What is primary hyperparathyroidism caused by?
adenoma
hyperplasia
carcinoma
16What is the most common cause of primary hyperparathyroidism?
chief cell adenoma
17What are the causes of secondary hyperparathyroidism?
diffuse glandular hyperplasia
CKD
calcium and vitamin D deficiency
18What are the common s/s of secondary hyperparathyroidism?
PUD
pancreatitis
n/v
weakness
fatigue
pruritus
anorexia
depression
muscle weakness
memory deficit/poor concentration
19Which mutation is related to type 1 FHH?
CASR
20Which mutation is related to type 2 FHH?
GNAS
21What s/s is associated with FHH?
usually asymptomatic but patient with have decreased urinary calcium
increased serum calcium
22What are signs of advanced disease associated with hypercalcemia of malignancy?
n/v
dehydration
confusion
coma
23What is elevated in hypercalcemia of malignancy?
PTHrp and calcium
24What are the causes of hypercalcemia of malignancy?
squamous cell tumors of lung and esophagus
renal cell carcinoma
breast carcinoma
lyphoma and leukemia
25What are the causes for hypoparathyroidism?
surgery
autoimmune destruction
tumor invasion of parathyroid
excess iron accumulation
26What lab values will you see with psuedohydroparathyroidism?
PTH high
calcium low
27What diseases of iron accumulation can cause hypocalcemia?
thalassemia
pseudohypoparathyroidism
28Hypocalcemia only occurs if ___ calcium is reduced
ionized
29What causes hypoalbuminemia?
hepatic cirrhosis
heart failure
malnutrion
chronic inflammatory disease
30What are the s/s of hypocalcemia?
spontaneous tonic muscular contractions
carpal spasms
laryngeal stridor
chvostek sign
trousseau sign