Risk Factors
Homeostasis
Bone Maintenance
Surgery and Post Op
100
This pair of risk factors for hyperparathyroidism is commonly found in teenagers. They typically spend most of their time indoors and replace a common childhood drink for soda.
What are vitamin D and Calcium Deficiency.
100
Decreased levels of this substance in the blood will cause activation of PTH
What is calcium.
100
These 2 major ions are located in the bone and are often indicative of hyperparathyroidism.
Ca2+ and Phosphate
100
Inserting Technetium-99m-methoxyisobutylisonitrile into the human body will cause these to darken in scintography.
What are glands.
200
Damage to the parathyroid would obviously have negative impacts on the production of PTH. How might this occur with a previous hx of cancer?
What is radiation therapy to the thyroid area.
200
This receptor in the parathyroid gland measures calcium and as a result releases PTH.
What is CaSR (Calcium sensing receptor) 200 more points if you can explain the process and how it keeps itself in check....
200
This is the basic unit of the bone structure
What is an osteon.
200
In the sestamibi scan, we have two time intervals of observation, 15 minutes and 2 hours. If we see a dark spot after two hours, we know its an...
What is adenoma. Explain why.
300
Women are more likely to have hyperparathyroidism. This is true primarily when a woman undergoing two "conditions" The first shows signs of increased hCG blood levels the second, perhaps increased levels of oxytocin and prolactin.
What are pregnancy and lactation.
300
PTH has an effect on these three organ systems but in different ways. Which three again?
What are the kidneys, Intestines, and Bone. (300 points if you can explain how PTH effects the effects on these three structures individually)
300
These three major cell types in the bone all start with osteo.
What is osteoblast, -clast, and -cyte
300
After removal of the adenoma, the patient can experience an acute case of hypocalcemia showing signs of peri-oral numbness and facial twitching This is caused by.....
What is tetany. Overstimulation of nerves due to the calcium drop. Bonus question (100pts) What is the syndrome called when the calcium drops?
400
A patient presents to your office and tells you that she has been feeling a bit tired. The labs show high serum calcium levels. Her family hx is significant for "some sort of neck cancer" from her mother and grandmother. Using this the doctor determine the mother potentially had this disease.
What is familial primary hyperparathyroidism
400
This hormone works against PTH effects and is activated after Ca2+ levels reach 9mg/dl
What is Calcitonin (100 more points if you explain what its primary targets are, where it came from, and generally how it works)
400
PTH has these two phases that have very interesting effects on the body.
What is rapid phase and slow phase. Explain what these two phases are and how they differ for full points.
400
In a hypocalcemic patient, you can look for this sign. Indicative of a fast drop in calcium.
What is Chvostek's sign. Explain what this is for full points.
500
A patient, a 35 y/o male who is moderately over-weight, presents with necrotic skin in parts of his extremities. He reports feeling relatively normal but the one thing you pick up on is his comment that he has increased his fast food intake for "awhile" because he craved the salty fries. Focusing on these two symptoms, the doctor would say he has.....leading to.....
What is primary hyperparathyroidism followed by excess calcium levels leading to micro deposits causing necrosis in small vessels.
500
The PTH works on the kidney so that it creates this substance that is especially important for bone maintenance. (You only get all the points if you explain how and why).
What is Vitamin D (1,25 hydroxycholecalciferol). PTH promotes transcription of enzymes for formation of active VitD from its precursor. This can then go to the intestines and increase calcium absorption. This will inhibit the parathyroid.
500
I ran out of bone questions.....awkward..... SOOOOOO..... Hyperparathyroidism has these two classifications.
What is primary and secondary. Explain the difference for full points.
500
If you didn't catch your patient's signs of hypocalcemia, their symptoms can worsen and become a more chronic problem. This could result in this behavior (A sort of shaking fit).
What is seizures. Why is this a particular problem in our patient? (for full points)
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