Term
| How do you calculate corrected calcium? |
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Definition
| ca= measured ca + 4 - Alb |
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Term
| You always have to evaluate a patients PTH in the context of their... |
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Definition
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Term
| What are the symptoms of primary hyperparathyroidism? |
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Definition
| moans (GI= vomiting, weight loss), stones, bones, groans |
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Term
| What are the causes of parimary hyperparathyroidism? |
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Definition
| single adenoma in 80-90% of cases; hyperplasia of all 4 glands in 10-20% of cases |
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Term
| hypercalcemia + decreased PTH = |
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Definition
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Term
| What other lab values besides serum calcium and PTH are affected by primary hyperparathyroidism? |
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Definition
| decreased serum phosphate (may not occur), chloride:phosphate ratio of more than 33 |
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Term
| What causes secondary hyperparathyroidism? |
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Definition
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Term
| What is the calcium, phosphate, and PTH levels in secondary hyperparathyroidism? |
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Definition
| high PTH with low calcium and elevated serum phosphate at first that is decreased when disease becomes chronic |
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Term
| What causes hypoparathyroidism? |
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Definition
| surgical removal of glands and idiopathic (most likely autoimmune) |
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Term
| What are the symptoms of hypoparathyroidism? |
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Definition
| numbness around the mouth, tetany, Chvostek's sign, and tTrousseau's sign |
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Term
| What is trousseau's sign? |
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Definition
| carpal spasm when you inflate the BP cuff |
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Term
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Definition
| lip spasm when you tap the facial nerve |
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Term
| What are the feature of pseudohypoparathyroidism? |
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Definition
| short stature, short fouth and fifth metacarpals, thick calvarium, mental changes |
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Term
| What is the pathology of pseudohypoparathyroidism? |
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Definition
| end organs are unresponsive to PTH |
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Term
| What are the PTH, calcium and phosphate levels in psuedo hypoparathyroidsim? |
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Definition
| increased PTH, low calcium, increased serum phosphate |
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Term
| What can cause ectopic production of TH? |
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Definition
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Term
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Definition
old use= diagnose hyperthyroidism, in which an injection of TRH would fail to increase TSH
current use= distinguish between secondary from tertiary hypothyroidism |
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Term
| How do you calculate the free thyroxine index? |
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Definition
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Term
| What is the T3U in hyperthyroidism? |
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Definition
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Term
| What is the T3U when a patient is euthyroid and has an elevated TBG? |
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Definition
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Term
| What is the T3U in a patient who is hypothyroid? |
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Definition
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Term
| What is the T3U in a patient who has decreased TBG and is euthyroid? |
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Definition
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Term
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Definition
| indirectly measures the number of unoccupied protein binding sites for T4 and T3 in the serum |
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Term
| What causes an increase in TBG? |
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Definition
| estrogen, pregnancy, acute hepatitis, congenital excess |
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Term
| What causes decrease in TBG? |
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Definition
| androgens, nephrotic syndrome, cirrhosis, congenital disease |
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Term
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Definition
| low during severe illness, hypothalamic or pituitary diseae, early pregnancy, dopamine, glucocorticoids, early after correction of hyperthyroidism |
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Term
| How long after correction of hyperthyroidism is TSH suppressed? |
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Definition
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Term
| How prevalent is thyroid dysfunction? |
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Definition
| 2% hypothyroid, .2% hyperthyroid |
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Term
| What are the nontropic hormones secreted by the anterior pituitary? |
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Definition
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Term
| Which endocrine glands are directly stimulated (no trophic hormones)? |
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Definition
| parathyroid, pancreatic islets, thyroid parafollicular cells |
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