Term
Primary Hyperparathyroidism:
- cause
- 3 lab findings |
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Definition
Cause: adenoma (usually)
Labs: ↑PTH, ↑Ca2+, ↑cAMP in urine |
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Term
Secondary Hyperparathyroidism:
- cause
- 2 lab findings |
|
Definition
Cause: from decreased intestinal Ca2+ and phosphate absorption (secondary to low vit. D in renal disease)
Labs: ↑PTH, ↓Ca2+ |
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Term
Tertiary Hyperparathyroidism:
- cause
- lab findings |
|
Definition
Cause: non-responsive hyperparathyroidism from chronic renal disease
Labs: ↑↑PTH, ↑Ca2+ |
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Term
| 3 symptoms of primary hyperparathyroidism |
|
Definition
Stones, bones, and groans:
calcium kidney stones
bone pain from osteitis fibrosa cystica
constipation |
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Term
| What is renal osteodystrophy? |
|
Definition
| bone lesions due to secondary or tertiary hyperparathyroidism due to renal disease |
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Term
| What is osteitis fibrosa cystica? |
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Definition
| cystic bone spaces filled with brown fibrous tissue (in primary hyperparathyroidism) |
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Term
| 3 causes of hypoparathyroidism |
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Definition
Accidental surgical excision
Autoimmune destruction
DiGeorge syndrome |
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Term
| 4 findings in hypoparathyroidism |
|
Definition
Hypocalcemia
Tetany
Chvostek's sign- tapping of facial nerve causes contraction of facial muscles
Trousseau's sign- occlusion of brachial artery with BP cuff causes carpal spasm |
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Term
What is pseudohypoparathyroidism?
Give 2 lab findings
Give 2 physical findings |
|
Definition
Is aka Albright's hereditary osteodystrophy:
Autosomal dominant kidney unresponsiveness to PTH
Labs: ↑PTH, ↓Ca2+
Physical: shortened 4th and 5th digits, short stature |
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Term
| How do you treat pituitary adenomas? |
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Definition
| Bromocriptine or cabergoline (dopamine agonists) |
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Term
What is acromegaly?
Give 5 signs/symptoms |
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Definition
Excess GH in adults (usually from a pituitary adenoma)
large tongue with deep furrows
deep voice
large hands and feet
coarse facial features
insulin resistance |
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Term
|
Definition
Acromegaly- Excess GH in children (increased linear bone growth)
(usually from a pituitary adenoma) |
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Term
| How to treat excess acromegaly? |
|
Definition
| resect tumor and follow with octreotide administration (a somatostatin analogue) |
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Term
| When does GH normally increase? (3) |
|
Definition
stress
exercise
hypoglycemia |
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Term
| How do you diagnose acromegaly? (2) |
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Definition
| Increase serum IGF-1 and failure to suppress serum GH following oral glucose tolerance test |
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Term
| What causes central vs. nephrogenic diabetes insipidus? |
|
Definition
Can't concentrate urine because:
central: no ADH
nephrogenic: lack of renal response to ADH |
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Term
| Name 4 causes of nephrogenic diabetes insipidus |
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Definition
Hereditary
2° to hypercalcemia
2° to lithium
2° to demeclocycline (ADH antagonist) |
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Term
| What do you give to treat central DI? |
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Definition
| intranasal desmopressin (ADH analogue) |
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Term
| What do you give to treat nephrogenic DI? (3) |
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Definition
Hydrochlorothiazide
Indomethacin
Amiloride |
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Term
| What result of a desmopressin test distinguishes between central and nephrogenic DI? |
|
Definition
central- desmopressin administration concentrates urine
nephrogenic- desmopressin doesn't change anything |
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