Usmle 1 Parathyroid Hormone

  1. Parathyroid Hormone
    • Phosphate Trashing Hormone (PTH)

    • • Be sure to check Phosphorus
    •   If Ca2+ and P are going in different direction
    •     Think PTH
    •   If Ca2+ and P are going in same direction
    •     Think Vitamin D

    • 2nd messenger for PTH = cAMP

    • • Calcitonin comes from c-cells of Thyroid
    •     Inhibit osteoclastic activity
  2. Parathyroid
    • Four small, pea-sized glands behind the thyroid gland

    • • Most common cancer:
    •     Adenocarcinoma

    • Men Syndromes

    Image Upload 2
  3. Actions of PTH
    • Stimulus: low calcium; high phosphorus
    • Inhibition: high calcium; low phosphorus

    • • Stimulates OSTEOCLASTIC ACTIVITY
    •   Cofactors  
    •     Vitamin A 
    •     Vitamin Mg

    • • ↑ Vitamin A
    •   Hypercalcemia
    •   Moans, Groans → pancreatitis
    •   Bones
    •   Stones

    • • Acts on the PCT of the kidney
    •   Waste Phosphorus (secrete it out)

    • • Vitamin D Action
    •   Activates 1-alpha hydroxylase
    •       Syn of the active form of vitamin D 1,25
    •    Ca2+ ATPase in the Late DCT
    •   ↑ GI absorption (jejunum) of Ca
    •   ↑ kidney reabsorption of Ca
    •    Ca2+ ATPase in the Late DCT
  4. Hypercalcemia
    • • MCC of Isolated Hypercalcemia 
    •     Parathyroid Adenoma
    •     Associated with MEN I and II
  5. Hyperparathyroidism
    • • Primary: due to parathyroid adenoma
    •   MCC of isolated hypercalcemia in adults

    • • Secondary: due to renal failure
    •   Renal Osteodystrophy
    •     Osteitis Fibrosa Cystica- fibrous tissue
    •     Osteopenia- low density
    •      Osteomalacia- nutrition (soft bones)
    •     Osteosclerosis- trauma
  6. Hypoparathyroidism
    • • Tetany
    •   involuntary contraction of muscles from ↓  calcium in blood
    •   MCC = Thyroidectomy

    • • ↓ PTH  
    • • ↓ Serum Calcium
    • • ↑ Serum P
  7. Pseudohypoparathyroidism
    • • ↑↑↑ PTH  
    • • ↓ Serum Calcium
    • • ↑ Serum P

    • Problem is with the receptors not working 

    • Kidney Problem
  8. Pseudo pseudo
    • Hypoparathyroidism

    • only difference is that calcium is normal
Author
docbrito
ID
362309
Card Set
Usmle 1 Parathyroid Hormone
Description
Usmle 1 Parathyroid Hormone
Updated