endo hyperparathyroidism

Question 1

define primary secondary and tertiary hyperparathyroidism

Answer 1

Primary hyperparathyroidism (pHPT): Hypercalcemia results from abnormally active parathyroid glands.
Secondary hyperparathyroidism (sHPT): Hypocalcemia results in reactive overproduction of PTH.
Tertiary hyperparathyroidism (tHPT): Hypercalcemia results from untreated sHPT, with continuously elevated PTH levels.

High phosphorus in tertiary, low in primary

Question 2

most common cause of primary and secondary hyperparathyroidism

Answer 2

Primary hyperparathyroidism
Parathyroid gland adenoma (∼ 85%): benign tumor of the parathyroid glands
Hyperplasia and multiple adenomas (∼ 15%)
In rare cases, carcinomas (∼ 0.5%) or idiopathic
MEN type 1 or 2
Lithium [3]
Secondary hyperparathyroidism
Chronic kidney disease (most frequent cause)
Malnutrition
Vitamin D deficiency (e.g., reduced exposure to sunlight, nutritional deficiency, liver cirrhosis)
Cholestasis

Question 3

what is the effect of parathyroid hormone on the kidneys

Answer 3

phosphaturia

Question 4

how does chronic kidney disease lead to increased parathyroid hormone

Answer 4

ckd leads to decreased phosphorus excretion leading to hyperphosphatemia which causes increased pth hormone secretion(remember this causes increased phosphorus excretion at level of kidneys)