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PARATHYROID

Terms in this set (24)

Chvostek's sign is associated with

A. Hypercalcemia
B. Hypocalcemia
B. Hypocalcemia
Tardive dyskinesia is associated with

A. Hypercalcemia
B. Hypocalcemia
B. Hypocalcemia
In primary hyperparathyroidism, how do the labs present?

Calcium ___
PTH ___
Vit D ___
Phosphorus ____

(high/low)
Calcium high
PTH high
Vit D norm/high
Phosphorus norm/low
Your patient presents to clinic with complaints of involuntary face grimacing and frequent eye blinking, you run their blood and they have hypocalcemia, what is this sign called?

A. Trousseau
B. Chovstek
C. Tardive dyskinesia
D. Akathesia
C. Tardive dyskinesia
Lethargy, nephrolithiasis, and constipation is associated with

A. Hypercalcemia
B. Hypocalcemia
Hypercalcemia
Why would we want to give furosemide to patients with primary hyperthyroidism?
It increases calcium secretion
Why do we want to avoid HCTZ in patients with primary hyperparathyroidism?
HCTZ increases renal absorption of calcium
In a patient with secondary/tertiary hyperparathyroidism how will their labs be different from primary?

PTH _____
Ca _____
PTH is high
Calcium low/norm
In a patient with secondary/tertiary hyperparathyroidism, who do you want to consult?
Nephrology
Most common cause of hypercalcemia?

A. Parathyroid adenoma
B. Chronic kidney dz
C. Vitamin D deficiency
A. Tumor is MC cause of primary hyperparathyroidism
Your 75 year old patient's lab work comes back. PTH levels are normal, but calcium is high, what is the most likely cause?

A. Parathyroid adenoma
B. Chronic kidney dz
C. Vitamin D deficiency
D. Malignancy
D. Malignancy
A patient has hypoparathyroidism and has had a partial resection of their thyroid. They are at risk for hungry bone syndrome. What does this mean?
Severe hypocalcemia

the remaining parathyroid glands become suppressed
Primary hypoparathyroidism can be caused by autoimmune destruction, elevated copper, elevated iron

how would you treat?
high dose calcium and vit D
You decide to give your patient high dose calcium. What is your main concern?
Stones
High levels of magnesium can _________ PTH

(increase/decrease)
Decrease/inhibit
Extremely low magnesium can cause a paradoxical block on PTH release
Take away --> Magnesium and Ca inversely related except in this instance
Pseudohypoparathyroidism = mutation in gene. There is end organ resistance to PTH

Labs look like

Ca ____
PTH _____
Ca low
PTH high
Pseudopseudohypoparathyroidism has gene mutation but has no end organ resistence.

Labs look like

Ca ____
PTH ____
Both are normal
Your patient has hypocalcemia. If your patient's parathyroid is working normally, what organ system do you want to blame next?
Kidneys. CKD
Your patient's labs come back and you notice they have hypercalcemia. You decide to order..
PTH, Mag, Vitamin D, creatinine
Your patient with hypocalcemia needs to have their blood pressure rechecked and you noticed they flexed their wrist involuntarily during inflation, what is this sign called?

A. Trousseau
B. Chovstek
C. Tardive dyskinesia
D. Akathesia
A. Trousseau
What labs do you want to order if you suspect a parathyroid issue?
Ca, Phos, Mag, PTH
Generally, how would you manage a patient with hyperparathyroidism?
Observe and consider surgery
Generally, how would you manage a patient with hypoparathyroidism?
Correct Ca and Vit D levels
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