Exam 3: Hyperparathyroidism Questions with Correct Solutions Rated A+

Hyperparathyroidism This is a condition involving an increased secretion of parathyroid hormone Parathyroid Hormone This hormone helps regulate serum calcium and phosphate levels by stimulating bone resorption of calcium, renal tubular reabsorption of calcium, and activation of vitamin D AD Oversecretion _____________of PTH is associated with increased serum calcium levels Primary Hyperparathyroidism Type of Hyperparathyroidism This type is due to an increased secretion of PTH leading to disorders of calcium, phosphate, and bone metabolism. The most common cause is a benign tumor in the parathyroid gland Lithium Long term __________ therapy is associated with primary hyperparathyroidism Secondary Hyperparathyroidism Type of Hyperparathyroidism This type is a compensatory response to conditions that induce or cause hypocalcemia, the main stimulus of PTH secretion. These conditions include vitamin D deficiencies, malabsorption, chronic kidney disease, and hyperphosphatemia Tertiary Hyperparathyroidism Type of Hyperparathyroidism This type occurs when there is hyperplasia of the parathyroid glands and a loss of negative feedback from circulating calcium levels. Thus there is autonomous secretion of PTH, even with normal calcium levels. Tertiary Type of Hyperparathyroidism This type is seen in patients who have had a kidney transplant after a long period of dialysis treatment for chronic kidney disease Hypercalcemia Hypophosphatemia Excessive levels of circulating PTH usually lead to what electrolyte imbalances? Hypercalciuria In the kidneys the excess calcium cannot be reabsorbed, leading to increased urinary calcium levels, also known as what? Hypercalcemia Clinical Manifestations Most manifestations are associated with ____________ -Loss of appetite -Emotional disorders -Fatigue -Shortened attention span -Muscle weakness Clinical Manifestations What are some common manifestations of hyperparathyroidism? AD 10 mg/dL Diagnostic Studies Serum calcium levels usually exceed ____ mg/dL 3 mg/dL Diagnostic Studies Because of its inverse relation with calcium, the serum phosphorus level is usually less than ____mg/dL Density Diagnostic Studies Bone _________ measurements may be used to detect bone loss Endoscopy Surgical Therapy The most commonly used procedure involves ____________ and is done on an outpatient basis 1 mg/dL Surgical Therapy Criteria for surgery involves elevated serum calcium levels, which are more than _____ mg/dL above the upper limit of normal 400 mg/day Surgical Therapy Criteria for surgery involves a manifestation of hypercalciuria, which is a level greater than _______ mg/day Autotransplantation Surgical Therapy Patients who have multiple parathyroid glands removed may undergo ______________ of normal parathyroid tissue in the forearm or near the sternocleidomastoid muscle. This allows PTH secretion to continue with normalization of calcium levels Immobility Nonsurgical Therapy Continued ambulation and avoiding ________ is very important Fluid Calcium Nonsurgical Therapy Dietary measures include high ______ and moderate __________ intake Biophosphates Nonsurgical Therapy ______________ inhibit osteoclastic bone resorption, normalizing serum calcium levels and improving bone mineral density Phosphates Nonsurgical Therapy ____________ are given if the patient has normal renal function and low serum phosphate levels