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8.5 Parathyroid & Calcium Pathophysiology — Test 1
Q1. Hypoparathyroidism results in:✓ Hypocalcemia (with tetany)
Q2. Primary hyperparathyroidism typically presents with:✓ Hypercalcemia with high PTH
Q3. Pseudohypoparathyroidism is caused by:✓ Target-organ resistance to PTH (often a Gs defect)
Q4. In pseudohypoparathyroidism, the response to exogenous PTH shows:✓ A blunted urinary cAMP response
Q5. Humoral hypercalcemia of malignancy is most often due to tumour secretion of:✓ PTH-related peptide (PTH-rp)
Q6. Familial hypocalciuric hypercalcemia (FHH) is caused by:✓ An inactivating mutation of the calcium-sensing receptor
Q7. Match each disorder with its calcium/PTH pattern and choose the correct option.✓ A-iii, B-ii, C-i
Q8. Secondary hyperparathyroidism (e.g. in chronic kidney disease) features:✓ High PTH driven by low calcium/active vitamin D
Q9. Which statement is NOT correct?✓ Hyperparathyroidism results in hypocalcemia
Q10. Tetany in hypoparathyroidism is due to:✓ Increased neuromuscular excitability from low ionized calcium
Q11. In primary hyperparathyroidism, serum phosphate is typically:✓ Low (due to phosphaturia)
Q12. A useful clue distinguishing FHH from primary hyperparathyroidism is:✓ Low urinary calcium in FHH
Q13. Renal osteodystrophy in chronic kidney disease results from:✓ Low active vitamin D, hypocalcemia and secondary hyperparathyroidism
Q14. In a patient with high calcium, the finding of LOW PTH points to:✓ A non-parathyroid cause (e.g. malignancy)
Q15. Treatment of acute severe hypercalcemia includes:✓ IV fluids, then bisphosphonates (± calcitonin)
Q16. Postmenopausal osteoporosis is primarily related to:✓ Estrogen deficiency increasing bone resorption
Q17. In hypoparathyroidism, serum phosphate is typically:✓ High (reduced phosphaturia)
Q18. The most common cause of primary hyperparathyroidism is:✓ A single parathyroid adenoma
Q19. A blunted urinary cAMP response to PTH, with high PTH and low calcium, indicates:✓ Pseudohypoparathyroidism (PTH resistance)
Q20. The single most useful test to classify a hypercalcemic patient is:✓ Serum PTH level