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Parathyroid Gland

  1. Yellow brown 30-40 mg; four glands
  2. Chief cells & oxphil cells
  3. 30% gland made of fat 

Hyperparathyroidism (primary) Q

  1. Common endocrine disorder
  2. Associated with hypercalcemia

Causes

Adenoma

  1. PRAD 1 on chromosome 11
  2. MEN I suppressor gene on 11 q 13

a. Composed of chief cell with few oxyphil cells

b. Rim of compressed parathyroid tissue

 

1. Primary hyperplasia

  1. Sporadic I MEN I & II A
  2. All 4 glands involved asymmetrically
  3. Chief cell ++; water clear cells ± 

2. # Parathyroid Carcinoma Q

  1. Single gland involved
  2. Local invasion/metastasis is only reliable criteria for diagnosis
  3. Ca+; PTH is diagnostic 

3. Secondary Hyperparathyroidism: Serum Ca++; PTH

  1. Commonly in renal failure
  2. Also in Vit D insufficiency; Steatorrhoea
  3. Parathyroid glands-Hyperplastic 

Tertiary Hyperparathyroidism: autonomous excessive parathyroid activity even when serum Ca++ is increased

Treatment - Parathyroidectomy

 

Hypoparathyroidism Q

  1. Surgical removal
  2. Congenital absence
  3. Primary auto immune




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