Parathyroid Pathology (PDF)

 Parathyroid Quick Facts ↳ - not regulated by pituitary - regulated by calcium level 4 tiny glands and rich blood supply – interaction with blood calcium Exclusive for calcium metabolism Make hormones PTH Measuremen...

 Parathyroid Quick Facts ↳ - not regulated by pituitary - regulated by calcium level 4 tiny glands and rich blood supply – interaction with blood calcium Exclusive for calcium metabolism Make hormones PTH Measurement of PTH in blood indicate its function Control calcium in blood and bones  NORMAL HOMEOSTASIS Chypocalcemein) r require vit D  WHAT CALCIUM DO TO OUR BODY? To provide the electrical energy for our nervous system. – Calcium is what the nervous system of our body uses to conduct electricity. – It stabilizes neuromuscular excitability , making nerves cells less sensitive to stimuli. – This is why the most common symptoms of parathyroid disease and high calcium levels are related to the nervous system.  WHAT CALCIUM eg DO TO OUR BODY? electrica -muscular teal EMSS -strength M system syste To provide the electrical energy for our muscular system. – Provide energy for cells to contract. Unregulated calcium can cause muscle cramps and weakness. To provide strength to our skeletal system. – to make our bones strong. The bones serve as the calcium storage system  Hyperparathyroidism Excess PTH secretion Primary : Tumor of parathyroid failure chronic renal Secondary : compensatory response to hypocalcemia often due to CRF- Interrupt calcium metabolism Cause increased bone resorption / osteoporosis, hypercalcemia, hypercalciuria  Primary Hyperparathyroidism ① Parathyroid adenoma (one / more glands). Increased PTH secretion increase in skeletal resorption with release of Ca2+ and Pi (inorganic phosphate) from bone. PTH also increased production of Vitamin D from renal Continue………… Cause increased Ca2+ and Pi absorption from the small intestine. PTH also enhances Ca2+ reabsorption and inhibits Pi reabsorption from renal causing increased urine Pi excretion. increase in ECF calcium and a decrease in ECF phosphate.  Secondary Hyperparathyroidism chronic rena failure Causes: CRF and malabsorption - Elevated PTH In CRF, cannot achieve normal calcium level. Long-term activation cause hyperplasia of the glands Loss sensitivity to circulating calcium Therefore cause autonomous secretion of PTH even with normal calcium levels Complication of HPTH Hyperparathyroidism : Treatment Treatment a. s e v e r e h y p e r c a l c e m i a – M E D I C A L EMERGENCY – death due to cardiac and neurological dysfunctions b. Use diuretic to increase calcium excretion c. Drug to inhibit bone resorption d. Surgical – primary hyperPTH secretion / ectopic secretion due to tumor  Abnormal / low PTH Etiology is multiple but among are thyroid surgery, autoimmunity, genetic mechanism and Di George syndrome (a total absence of the parathyroid glands at birth) Clinical finding: Depressed calcium , increased phosphate, decreased bone resorption, hypocalciuria. Treatment : Calcium and Vitamin D replacement therapy often works but develop risk of kidney stones  Complication of HypoPTH Paresthesia, an unpleasant tingling sensation around the mouth and in the hands and feet. Muscle cramps and severe spasms known as "tetany" that affect the hands and feet. Other subjective symptoms such as fatigue, headaches, bone pain and insomnia. Severe irregularities in the normal heart beat. Spasm of the airways causing respiratory failure. I surrender! Please, no more hormones !!! Thyroid