PAEA Surgery End Of Rotation (EOR) Practice Exam

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What is a key characteristic of tertiary hyperparathyroidism?

Responsive to normal feedback
Confined to adolescence
Autonomous PTH secretion
Associated with genetic syndromes

The correct answer is: Autonomous PTH secretion

A key characteristic of tertiary hyperparathyroidism is autonomous PTH secretion. In this condition, the parathyroid glands become hyperplastic and secrete parathyroid hormone (PTH) independently of the calcium levels in the bloodstream. This often occurs in patients with chronic renal failure, where prolonged low calcium levels due to renal disease lead to persistent stimulation of the parathyroid glands. Over time, the glands can become autonomous, meaning they continue to secrete PTH regardless of the normal feedback mechanisms that would typically regulate their activity based on calcium levels. The other characteristics mentioned do not accurately describe tertiary hyperparathyroidism. The condition is not responsive to normal feedback mechanisms, as the autonomous secretion bypasses these controls. It is not confined to adolescence, as it can occur at any age, particularly in individuals with renal disease. While it may be associated with various medical conditions, it is not primarily tied to genetic syndromes the way some other forms of hyperparathyroidism are.