128: Parathyroid Flashcards
adenoma or hyperplasia of the parathyroids causing excess PTH and elevated calcium.
primary hyperparathyroidism
low calcium resulting from any cause leading to increased PTH
secondary parathyroidism
long term hypocalcaemia causing autonomous compensatory increase in PTH production.
tertiary hyperparathyroidism
malignancy results in increased osteoclast bone resorption
hypoparathyroidism
symptoms of hyperpapathyroidism
can be asymptomatic but can cause tiredness, weakness, dehydration, anorexia, nausea, vomiting, polyuria, mental confusion, peptic ulcers, soft tissue calcification, cardiac arrhythmias, bone pain, osteoporosis, kidney stones.
primary hyperparathyroid investigations…
high PTH, High Calcium, low PO4, high urinary calcium
secondary hyperparathyroid investigations…
compensatory high PTH, normal Ca, high PO4
tertiary hyperparathyroid investigations…
high PTH, high Ca, low PO4
malignant hypercalcaemia investigations
high Ca, low PO4
hypoparathyroidism investigations
low PTH, Low Ca, High PO4
hypomagnesaemia symptoms
increased neuromuscular excitability, tingling of extremities, tetany, epileptic convulsions, ECG abnormalities ( prolongued QT interval), cataracts.
what is pseudohypoparathyroidism and when would you consider it?
caused by resistance to PTH rather than lack of it. See it with Albright’s Hereditary Dystrophy ( short round face and neck, short metacarpals). investigations show high PTH, low Ca, High PO4 but also urine cAMP response to PTH deficient.
what is osteomalacia
bone fractures and myopathy caused by vitamin D deficiency.
investigations for osteomalacia reveal…
high PTH, Low Ca, Low PO4, Low Vitamin D
how do you treat pseudohypoparathyroidism
Vitamin D
