Rav Endocrinology Parathyroid- Mksat

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* Calcium and phosphorus balance is maintained within a narrow physiologic range through the interactions of

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* Calcium and phosphorus balance is maintained within a narrow physiologic range through the interactions of parathyroid hormone, vitamin D, and, to a lesser extent, calcitonin.

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provides the best indicator of total body vitamin D stores.

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* Measurement of serum levels of 25-hydroxy vitamin D3 provides the best indicator of total body vitamin D stores.

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when Serum parathyroid hormone (PTH) levels are elevated or suppressed

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* Serum parathyroid hormone (PTH) levels are elevated or inappropriately normal in the PTH-mediated causes of hypercalcemia and are suppressed in the non–PTH-mediated causes.

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common cause of hypercalcemia

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* Primary hyperparathyroidism is the most common cause of hypercalcemia in the outpatient setting; cancer is the most common cause in hospitalized patients.

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preferred surgical treatment of primary hyperparathyroidism.
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* Minimally invasive parathyroidectomy with intraoperative measurement of the parathyroid hormone level is becoming the preferred surgical treatment of primary hyperparathyroidism.
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Hyperparathyroidism associated with the multiple endocrine neoplasia syndromes typically involves

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Hyperparathyroidism associated with the multiple endocrine neoplasia syndromes typically involves four-gland hyperplasia, is associated with additional endocrine syndromes, and requires removal of three or more glands for surgical cure.
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The most common cause of acquired hypocalcemia

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The most common cause of acquired hypocalcemia is surgical excision of or vascular injury to the parathyroid glands during neck surgery.
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Acute symptomatic hypocalcemia should be treated with

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Acute symptomatic hypocalcemia should be treated with intravenous calcium gluconate.
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In hypoparathyroidism, the serum calcium level should be maintained in the low-normal range to prevent

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In hypoparathyroidism, the serum calcium level should be maintained in the low-normal range to prevent hypercalciuria, renal stones, and renal failure.
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Osteoporosis is present when the T-score is

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Osteoporosis is present when the T-score is below –2.5 on bone mineral densitometry.
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reduce the risk of both vertebral and nonvertebral fractures in patients with osteoporosis

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Oral alendronate, oral risedronate, and subcutaneous teriparatide reduce the risk of both vertebral and nonvertebral fractures in patients with osteoporosis; annual intravenous administration of zoledronate significantly reduces the risk of both vertebral and hip fractures in women.
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Osteomalacia is characterized by

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Osteomalacia is characterized by decreased bone mineralization and low or normal ionized calcium, normal or high parathyroid hormone, and low vitamin D levels.
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Paget disease .. when should be treated

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Paget disease should be treated if symptoms are present or if lytic involvement of the vertebrae, skull, weight-bearing bones, or areas adjacent to major joints occurs; bisphosphonates are the therapeutic agents of choice for Paget disease.