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17 terms

E L11 path of the parathyroid glands & MEN dr.trif

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What type of cells are in the parathyroid gland?
•Chief cells - light pink
•Oxyphilic cells - larger cells with acidophilic cytoplasm
What is the main role of PTH?
To increase serum Ca. secretion increased in low Ca, and decreased in high Ca states.
What are the symptoms for hypercalcemia?
MISHAP
•Malignancy
•intoxication with vit D
•Sarcoidosis
•Hyperthyroidism
•Alkali (milk-alkali syndrome)
•Paget's dz
What is the MCC of hypercalcemia?
*Malignancy
How do malignancies cause hypercalcemia?
•metastatic tumor cells → cytokine release → osteolytic metastasis→ osteolysis
•release of PTH-related protein (PTHrP) by solid tumors (Sq cell cancers) --- appears in the absence of osteolytic metastasis called humoral hypercalcemia of malignancy
***What is Familial Hypocalciuric Hypercalcemia?
A mutation in the calcium sensing receptor gene (CaSR) causing the parathyroid gland to have decreased sensitivity to extracellular calcium levels
What histological marker do you expect to find in Osteitis Fibrosa Cystica?
Metastatic calcifications
What are the symptoms of Osteitis Fibrosa Cystica?
Painful bones, renal stones, abdominal groans, psychic moans
What are the lab findings in Osteitis Fibrosa Cystica?
*High serum alkaline phosphatase, high urinary calcium
What is the MCC of 2° hyperparathyroidism?
Chronic renal failure
What are the lab findings in 2° hyperparathyroidism?
High serum alkaline phosphatase
What are the causes of hypOcalcemia?
•Hypoparathyroidism (PTH deficiency)
•Pseudohypoparathyroidism (failure to respond to PTH)
What are some symptoms oh hypOparathyroidism?
•MSK: tetany, Chvosek sign, Trousseau sign, laryngospasm
•CV: prolonged QT→arrythmias
•increased ICP (intracranial pressure)
What are the 2 types of Pseudohypoparathyroidism?
• Pseudohypoparathyroidism type 1A --- AHO and multihormone resistant
•pseudo- Pseudohypoparathyroidism --- AHO but not multihormone resistant
What is AHO?
Albright Hereditary Osteodystrophy - short stature, obese, short metacarpal and metatarsals, variable mental defects
What is multidrug resistance?
•PTH resistance → hypocalcemia, hyperphosphatemia, elevated serum PTH
•TSH resistance → mild symptoms
•FSH/LH resistance → hypogonadism
What does Multiple organ Endocrine Neoplasia (MEN) 1 (Werner syndrome) affect?
The 3 P's
•Parathyroid - 1° hyperparathyroidism
•Pancreas - ZE syndrome, pancreatic tumors,
•Pituitary glands - prolactinoma