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Hospital and Internal Medicine Podcast

Hyperparathyroidism - Hypercalcemia part 3

Hospital and Internal Medicine Podcast

Gil Porat, M.D., FACP, CPT

Health & Fitness, Fitness, Science, Health & Fitness:medicine, Medicine

4.7587 Ratings

🗓️ 6 June 2015

⏱️ 19 minutes

🧾️ Download transcript

Summary

Indications for parathyroidectomy, pre-operative localization issues, diagnosing hyperparathyroidism, and a brief summary of the guidelines are among the topics addressed in this episode.

Transcript

Click on a timestamp to play from that location

0:00.0

Here's an interesting fact. Four is the only number that has the same number of alphabet characters as its value in the English language.

0:09.7

And perhaps of more importance, there are also four parathyroid glands.

0:16.0

Normal parathyroids are not visible or able to be felt during examination of the neck. They typically are two

0:24.2

pairs of glands most commonly found behind the left and right lobes of the thyroid. And when you hear

0:31.5

the word parathyroid, your mind probably flashes to the image of an Indian rhinoceros

0:38.2

because that is the magnificent animal they were first discovered in.

0:43.0

What's that?

0:44.0

You haven't seen an Indian rhino?

0:47.0

Well, that's because the one's very prominent animal has been hunted to near extinction,

0:53.0

mostly a result of shooting them for the fun of it,

0:56.4

while those not killed for sport are often slaughtered by poachers selling their body parts. Ah, humans. It's the

1:02.8

great paradox of my life. I truly care for humans, but don't trust many of them. With that

1:08.6

disclosure, having been said, I will go on to say, this lecture is another

1:13.3

part of a series on hypercalcemia and will focus on the diseases of hyperparathoridism.

1:19.9

To grasp all the concepts discussed, it's important to understand the previous discourse already

1:25.1

had about hypercalcemia, and I will also try not to repeat

1:29.2

the several things of heretofore mentioned about hyperparathyroidism, though I warn you,

1:35.1

I'm one of those guys that even when I know the past, I am doomed to repeat it.

1:40.1

So at a very basic level, when calcium levels increase, the calcium is sensed in a normal functioning

1:47.9

parathyroid gland by the calcium sensing receptor. And as a result, there is a decrease in

1:55.4

PTH secretion. Now I'm going to be saying PTH for parathyroid hormone frequently.

2:01.5

The reverse of that is when calcium levels drop and you have healthy glands, PTH is secreted.

...

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