[Endo] Calcium Homeostasis Flashcards
what is hyperparathyroidism (hPTH) classified into?
- primary
- secondary
- tertiary
what is primary hPTH?
PTH secretion from a primary parathyroid adenoma or as an ectopic secretion from another tumour
what is secondary hPTH?
parathyroid hyperplasia to control chronic hypocalcaemia, which is usually a result of CKD
what is tertiary hPTH?
prolonged parathyroid hyperplasia, which is irrepressible by serum calcium levels. mostly occurs in kidney transplant pts
what should pts with CKD have checked every 3-6 months?
bone profile and parathyroid hormone
calcium - high
phosphate - low
type of hPTH?
primary
rx for primary hPTH?
parathyroidectomy for most
calcium - normal
phosphate - high
type of hPTH?
secondary
rx for secondary hPTH?
treat CKD: rx hyperphosphataemia with phosphate binders e.g. calcium carbonate, sevelamer hydrochloride
calcium - high
phosphate - high (if no transplant), low (if transplant)
type of hPTH?
tertiary
rx for tertiary hPTH?
mostly self-limiting
requires surgery if refractory hypercalcaemia or symptomatic
what at Multiple Endocrine Neoplasias (MEN)?
an autosomal dominant group of genetic disorders that cause certain patterns of tumour growth
what are the types of MEN?
MEN 1, 2a, 2b
what is the affected gene in MEN 1 and what are its tumour patterns?
MEN 1
3Ps:
Pituitary adenoma
Parathyroid adenoma
Pancreatic neuroendocrine tumour
what are the extra features of MEN 1?
angiofibromas
meningiomas
