PTH, Ca, Phosphate, Vit D
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| Parathyroid hormone (PTH) functions | maintain blood Ca concentration
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| PTH actions | increase Ca resorption from bone; increase Ca reabsorption from kidney; increase Ca absorption in intestines
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| PTH directly stimulates: | bone (Ca and phosphorous resorption), kidney (production of calcitriol; Ca reabsorption; phosphorous excretion)
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| PTH indirectly (through the kidney) stimulates: | bone resorption of Ca and phosphorous, intestinal absorption of Ca and phosphorous
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| Increased phosphorous causes _____ (increased or decreased) PTH: | increased PTH
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| Increased Ca causes _____ (increased or decreased) PTH: | decreased PTH
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| Decreased Ca causes _____ (increased or decreased) PTH: | increased PTH
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| Decreased phosphorous causes _____ (increased or decreased) PTH: | decreased PTH
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| Phosphorous and PTH have what kind of relationship? | Direct relationship
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| Ca and PTH have what kind of relationship? | Inverse relationship
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| Increased calcitriol causes _____ (increased or decreased) PTH: | decreased PTH
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| Decreased calcitriol causes _____ (increased or decreased) PTH: | increased PTH
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| Calcitriol = ? | active vitamin D; 1,25-dihydroxy vitamin D
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| Calcitriol and PTH have what kind of relationship? | inverse relationship
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| Parathyroid studies | PTH, serum Ca, serum phosphorous
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| Primary hyperparathyroidism levels | Inreased Ca; decreased-to-normal phosphorous; increased PTH
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| Secondary hyperparathyroidism | normal Ca; increased phosphorous; increased PTH
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| Hypoparathyroidism | decreased Ca; increased phosphorous; decreased PTH
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| Pseudohypoparathyroidism | decreased Ca; increased phosphorous; increased PTH
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| Pseudohypoparathyroidism is a problem with: | decreased tissue sensitivity to PTH (increased resistance to PTH)
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| Hypoparathyroidism is a problem with: | deficiency of PTH
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| Hyperparathyroidism is a problem with: | abnormally increased PTH
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| Secondary hyperparathyroidism is a problem with: | renal insufficiency
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| Most common cause of hypercalcemia in ambulatory patients | hyperparathyroidism
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| Most frequent patient population of hyperparathyroidism | postmenopausal women
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| 80% of hyperparathyroidism cases are due to: | solitary parathyroid adenoma
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| 18% of hyperparathyroidism cases are due to: | hyperplasia of all 4 parathyroid glands
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| Primary hyperparathyroidism | caused by one or more hyperfunctioning parathyroid glands that secrete excess PTH
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| Primary hyperparathyroidism causes increased Ca due to: | increased bone resorption, increased kidney reabsorption, increased intestinal absorption
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| Primary hyperparathyroidism is caused by: | adenoma, hyperplasia, carcinoma
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| Secondary hyperparathyroidism is caused by: | pathological condition outside of the parathyroid glands, usually due to long-standing renal insufficiency
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| Secondary hyperparathyroidism leads to: | chronic hypocalcemia (due to decreased renal reabsorption of Ca); increased PTH levels (trying to increase Ca levels); parathyroid gland hyperplasia (due to elevated PTH)
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| Hyperparathyroidism s/s | stones, bones, abdominal groans, psychic moans, fatigue overtones
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| Most common presentation of hyperparathyroidism | asymptomatic!
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| hyperparathyroidism diagnostic studies | Ca (high in primary, normal in secondary); phosphorous (low-normal in primary, high in secondary); PTH (high in primary and secondary)
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| Hyperparathyroidism treatment | primary (none, surgical excision); secondary (restrict dietary phosporous, phosphate-binding resins, vitamin D, calcitriol) - goal is raise serum Ca level
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| Hypoparathyroidism is caused by: | 80% is caused by neck surgery (thyroid or parathyroid surgery); severe magnesium deficiency
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| Pseudohypoparathyroidism is caused by: | increased target organ/tissue resistance to PTH
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| Hypoparathyroidism s/s | s/s of hypocalcemia
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| Chvostek's sign | involuntary twitching of the facial muscles initiated by light tapping of the facial nerve anterior to the auditory meatus
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| Trousseau's sign | carpopedal spasm due to reduction in blood supply (BP cuff inflated for a few minutes above elbow)
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| Hypoparathyroidism diagnostic studies | Ca (low in both); phosphorous (elevated in both); PTH (decreased in hypoparathyroidism, elevated in pseudohypoparathyroidism)
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| Hypoparathyroidism treatment | acute (IV Ca, calcitriol); chronic (vitamin D, dietary Ca supplements)
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| Pseudohypoparathyroidism treatment | vitamin D, dietary Ca supplements
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Created by:
Carrie D.
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