please help with this nbde1 question

[Mrs ali]

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hello everyone
i came through this question in the 2004 pilot exam
a woman with hyperparathyriodism which of the following will most likely be increased:
1.intestinal ca absorption
2 intestinal organic phosphate absorption
3 renal calciterol production
4 renal ca excretion
5 renal organic phosphate excretion
it says the answer is 4..but i was thinking it should be 1 because this is the function of parathyriod hormone????

 

[indiak]

hey mrs ali
parathyroid does increase calcuim absorption from intestine and increase plasma calcium.i think answer to hyperparathyroidism question should be increase intestinal calcuim absorption.

 

[Mrs ali]

hey mrs ali
parathyroid does increase calcum absorption from intestine and increase plasma calcium.i think answer to hyperparathyroidism question should be increase intestinal calcuim absorption.

yes thats what what i was thinking but the answer written that there's increased ca excretion by kidney!!!

 

[dentistjpr]

Primary hyperparathyroidism

• The most common cause is a benign parathyroid adenoma that loses its sensitivity to circulating calcium levels. Usually, only one of the four parathyroid glands is affected.
• A less common cause is from multiple endocrine neoplasia (MEN).

Secondary hyperparathyroidism

Secondary hyperparathyroidism is due to excessive secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcemia (low blood calcium levels) and/or hyperphosphatemia (high blood phosphatechronic renal failure. The bone disease in secondary parathyroidism along with renal failure is termed renal osteodystrophy.



From what i understood they are implying the lady has secondary hyperparathyroidism which occurs due to renal failure and loss of excessive serum calcium which in turn increases PTH secretion. Under normal situations PTH increses intestinal ca absorption but the incresed PTH levels occur only in the above 2 scenarios most commonly and they certainly dont affect the intestinal calcium levels.


I think.....correct me if I am wrong

 

[tanyast]

PTH acts on intestinal mucosa indirectly, through situmation of sinthesis on D3 in kidney, which in turn will enhance intestinal absorbtion of Ca. Direct effect of PTH is increase secretion of phosphate by kidney and increase reabs of Ca by kidney.
Are you sure it is 4 and not 5 the right answer?

 

[dentgod]

hello dentistjpr,
I'm with answer choice 1 as evrybody. I went thru your explanation n don understand still, can you make it lil explanatory for people like me. thanks in advance.

 

[IMPACT]

Primary hyperparathyroidism

• The most common cause is a benign parathyroid adenoma that loses its sensitivity to circulating calcium levels. Usually, only one of the four parathyroid glands is affected.
• A less common cause is from multiple endocrine neoplasia (MEN).

Secondary hyperparathyroidism

Secondary hyperparathyroidism is due to excessive secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcemia (low blood calcium levels) and/or hyperphosphatemia (high blood phosphatechronic renal failure. The bone disease in secondary parathyroidism along with renal failure is termed renal osteodystrophy.



From what i understood they are implying the lady has secondary hyperparathyroidism which occurs due to renal failure and loss of excessive serum calcium which in turn increases PTH secretion. Under normal situations PTH increses intestinal ca absorption but the incresed PTH levels occur only in the above 2 scenarios most commonly and they certainly dont affect the intestinal calcium levels.


I think.....correct me if I am wrong

Guyz this question is about secondary hyperthyroidism for sure and the above explanation is just perfect.ASDA has very few such weird answers but in such cases I guess its just best to know the answer given in released exams.

Here's another one

Lingual height of contour on the crown on Mandibular 2nd PM?
1. Middle third
2. occlusal third
3. same third as its buccal HOC
4. same third as lingual HOC of max premolars
5. same third as lingual HOC of Mand 1st PM

Answer given is 2.

 

[dentistjpr]

hello dentistjpr,
I'm with answer choice 1 as evrybody. I went thru your explanation n don understand still, can you make it lil explanatory for people like me. thanks in advance.

What i meant was...." renal failure which causes loss of excessive calcium in the body triggers the parathyroid response wherein the parathyroid hormone secretion increases and therefore in called secondary hyperparathyroidism.

Although Under normal situations PTH increases intestinal Ca absorption, THE INCREASED OR ABNORMAL LEVELS OF THIS HORMONE OCCUR ONLY IN THESE 2 SCENARIOS PRIMARILY and they certainly dont affect the intestinal calcium levels.

i hope i am clear now............sorry if it still sounds confusing.

 

[Mrs ali]

thank you all for the replys but it still doesnt explain why there is increased renal excretion either in primary or secoundry hyperparathyroidism.
i have another question for u guys does cementum have incremental lines???

 

[indiak]

thx dentistjpr ..its clear now

 

[indiak]

mrs ali i think cementum does have incremental lines;i am not sure but that will be my answer

 

[pbkal]

Lingual height of contour on the crown on Mandibular 2nd PM?
1. Middle third
2. occlusal third
3. same third as its buccal HOC
4. same third as lingual HOC of max premolars
5. same third as lingual HOC of Mand 1st PM

Answer given is 2.

i thuought 1 as ans..pls confirm the right ans..