23 Parathyroid ANATOMY AND PHYSIOLOGY
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Questions and Answers

Where are the superior parathyroids located?

  • Medial to recurrent laryngeal nerves, more anterior, below inferior thyroid artery
  • Intra-thyroid, mediastinal, near tracheoesophageal groove
  • In the tail of the thymus
  • Lateral to recurrent laryngeal nerves, posterior surface of superior portion of gland, above inferior thyroid artery (correct)

    • Which artery supplies blood to both superior and inferior parathyroid glands?

  • Superior thyroid artery
  • Brachiocephalic trunk
  • Inferior thyroid artery (correct)
  • Carotid artery

    • What is the most common ectopic site for inferior parathyroids?

  • Intra-thyroid
  • Near tracheoesophageal groove
  • Mediastinal
  • In the tail of the thymus (correct)

    • Which pharyngeal pouch is associated with the inferior parathyroids?

    <p>3rd pharyngeal pouch</p> Signup and view all the answers

    Which of the following conditions is characterized by a defect in the PTH receptor in the distal convoluted tubule of the kidney, leading to increased resorption of calcium?

    <p>Familial hypercalcemic hypocalciuria</p> Signup and view all the answers

    What is the treatment for familial hypercalcemic hypocalciuria?

    <p>No treatment is required</p> Signup and view all the answers

    Which condition results from a defect in the PTH receptor in the kidney, making it unresponsive to PTH?

    <p>Pseudohypoparathyroidism</p> Signup and view all the answers

    In which location is lung most commonly affected by metastases in parathyroid cancer?

    <p>Lung</p> Signup and view all the answers

    What is the 5-year survival rate for parathyroid cancer?

    <p>50%</p> Signup and view all the answers

    Which gene mutation is associated with MEN I syndrome?

    <p>MENIN gene</p> Signup and view all the answers

    What is the primary cause of death in patients with MEN IIa and MEN IIb syndromes?

    <p>Medullary thyroid carcinoma</p> Signup and view all the answers

    Which condition is the most common cause of outpatient hypercalcemia?

    <p>Hyperparathyroidism</p> Signup and view all the answers

    What is the mechanism of action of Mithramycin in treating hypercalcemia?

    <p>Inhibits osteoclasts</p> Signup and view all the answers

    Which type of cancer can release PTHrP, leading to hypercalcemia?

    <p>Breast cancer</p> Signup and view all the answers

    What is the primary cause of hypercalcemic crisis?

    <p>Hyperparathyroidism</p> Signup and view all the answers

    What is the prevalence of pheochromocytoma in MEN IIa syndrome?

    <p>Nearly all patients</p> Signup and view all the answers

    What is the primary role of parathyroid hormone (PTH) in the body?

    <p>Increasing renal calcium reabsorption</p> Signup and view all the answers

    What is the most common cause of hypoparathyroidism?

    <p>Previous thyroid surgery</p> Signup and view all the answers

    Which hormone decreases serum calcium levels?

    <p>Calcitonin</p> Signup and view all the answers

    What is the characteristic bone lesion seen in hyperparathyroidism?

    <p>Osteitis fibrosa cystica (brown tumors)</p> Signup and view all the answers

    What are the symptoms of primary hyperparathyroidism?

    <p>Muscle weakness, nephrolithiasis, and depression</p> Signup and view all the answers

    What diagnostic workup is recommended for primary hyperparathyroidism?

    <p>Serum protein electrophoresis and 24-hour urinary calcium determination</p> Signup and view all the answers

    What is the treatment for parathyroid adenoma?

    <p>Total parathyroidectomy with autotransplantation</p> Signup and view all the answers

    What is the management approach for missing parathyroid glands during surgery?

    <p>Checking inferiorly in thymus tissue for ectopic location</p> Signup and view all the answers

    What is the most common location for a missing parathyroid gland during surgery?

    <p>Intra-thyroid</p> Signup and view all the answers

    What can cause hypocalcemia postoperatively after parathyroid surgery?

    <p>Bone hunger or failure of parathyroid remnant/graft</p> Signup and view all the answers

    What is the preferred imaging modality for locating overactive parathyroid glands?

    <p>Sestamibi scan</p> Signup and view all the answers

    What is the management approach for secondary hyperparathyroidism in patients with renal failure?

    <p>Control diet phosphate and use phosphate-binding gel (sevelamer chloride)</p> Signup and view all the answers

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