A 37 year old female presents to her physicianâs office with acute pain over her right flank and persistent abdominal pain. Additionally, she reports a 2 year history of generalized fatigue and depression associated with difficulty concentrating and significant mood swings. She has no history of drug or alcohol use and no significant family history. Following ultrasound examination she is diagnosed with a kidney stone. Laboratory tests of serum parathyroid levels reveal an abnormally high parathyroid hormone concentration of 125 pg/mL. The patient is further diagnosed with hyperparathyroidism and it is determined that exploratory surgery is needed. Once the parathyroid glands have been exposed they are visually and physically examined. On palpation a small mass is found on the right inferior parathyroid gland and removed. Parathryoid hormone levels were monitored until returning to normal limits.
Guiding Questions
A 37 year old female presents to her physicianâs office with acute pain over her right flank and persistent abdominal pain. Additionally, she reports a 2 year history of generalized fatigue and depression associated with difficulty concentrating and significant mood swings. She has no history of drug or alcohol use and no significant family history. Following ultrasound examination she is diagnosed with a kidney stone. Laboratory tests of serum parathyroid levels reveal an abnormally high parathyroid hormone concentration of 125 pg/mL. The patient is further diagnosed with hyperparathyroidism and it is determined that exploratory surgery is needed. Once the parathyroid glands have been exposed they are visually and physically examined. On palpation a small mass is found on the right inferior parathyroid gland and removed. Parathryoid hormone levels were monitored until returning to normal limits.
Answer the questions below.
1. Given what you know about the function of the parathyroid gland what is another substance in the blood serum that you would expect to be outside of normal limits?
2. Predict which muscular structures the surgeon needs to reflect or cut to reach the parathyroid glands from an anterior midline approach. Identify which vascular and nervous structures will need to identified and avoided to prevent injury. If you need help visualizing this, Biodigital is a great tool to utilize.
3. What are the upstream regulators of parathyroid function? In other words, what is the normal flow of information to either stimulate or suppress parathyroid function?
4. What are the downstream effectors that the parathyroid hormone acts on? How does this explain the symptoms our patient presented with?
A 37 year old female presents to her physicianâs office with acute pain over her right flank and persistent abdominal pain. Additionally, she reports a 2 year history of generalized fatigue and depression associated with difficulty concentrating and significant mood swings. She has no history of drug or alcohol use and no significant family history. Following ultrasound examination she is diagnosed with a kidney stone. Laboratory tests of serum parathyroid levels reveal an abnormally high parathyroid hormone concentration of 125 pg/mL. The patient is further diagnosed with hyperparathyroidism and it is determined that exploratory surgery is needed. Once the parathyroid glands have been exposed they are visually and physically examined. On palpation a small mass is found on the right inferior parathyroid gland and removed. Parathryoid hormone levels were monitored until returning to normal limits.
Guiding Questions
A 37 year old female presents to her physicianâs office with acute pain over her right flank and persistent abdominal pain. Additionally, she reports a 2 year history of generalized fatigue and depression associated with difficulty concentrating and significant mood swings. She has no history of drug or alcohol use and no significant family history. Following ultrasound examination she is diagnosed with a kidney stone. Laboratory tests of serum parathyroid levels reveal an abnormally high parathyroid hormone concentration of 125 pg/mL. The patient is further diagnosed with hyperparathyroidism and it is determined that exploratory surgery is needed. Once the parathyroid glands have been exposed they are visually and physically examined. On palpation a small mass is found on the right inferior parathyroid gland and removed. Parathryoid hormone levels were monitored until returning to normal limits.
Answer the questions below.
1. Given what you know about the function of the parathyroid gland what is another substance in the blood serum that you would expect to be outside of normal limits?
2. Predict which muscular structures the surgeon needs to reflect or cut to reach the parathyroid glands from an anterior midline approach. Identify which vascular and nervous structures will need to identified and avoided to prevent injury. If you need help visualizing this, Biodigital is a great tool to utilize.
3. What are the upstream regulators of parathyroid function? In other words, what is the normal flow of information to either stimulate or suppress parathyroid function?
4. What are the downstream effectors that the parathyroid hormone acts on? How does this explain the symptoms our patient presented with?
