Endocrine Biochem Results Flashcards
High Ca2+, high PTH
Low serum phosphate
Primary hyperparathyroidism
Low Ca2+, high PTH
and high phosphate
Secondary hyperparathyroidism
PTH is high in (physiological) response to low Ca, so reduced negative feedback e.g. chronic renal failure (which also results in increased serum phosphate)
High Ca2+, high PTH
and high phosphate
Tertiary hyperparathyroidism
Occurs after long-term secondary hyperparathyroidism
Low Ca2+, high PTH, high phosphate and short fourth and fifth metacarpals
Pseudohypoparathyroidism
Low calcium results in high PTH (as it should)
Note: biochem is all normal in pseudo-pseudohypoparathyroidism, but phenotype remains
High Ca2+, high Alk phos, normal phosphate, normal PTH
Malignancy
Low Ca2+, high PTH, high alk. phos, low phosphate
Osteomalacia (Rickets)
Note: Ca2+ and phosphate are normal in osteoporosis
High serum Ca2+, high (or normal) PTH, low urine Ca2+
Familial Hypocalciuric Hypercalcaemia
High alk phos, normal calcium, normal phosphate
Paget’s disease (increased bone turnover, results in bone pain, deformity & headaches due to compression)
Note Ca2+ may be increased after a period of immobilisation
Suggest what biochemical results you may expect in malignancy
(Ca2+, alk phos, phosphate and PTH level)
High calcium and alk phos.
Low PTH (due to high calcium and increased feedback)
Normal phosphate
Suggest what biochemical results you may expect in primary hyperparathyroidism
(Ca2+, alk phos, phosphate and PTH level)
High PTH, high Ca2+
Normal alk phos
Low phosphate (due to high PTH)
(Calcium is high due to increased PTH…parathyroid hormrone works to increase plasma calcium levels)
Suggest what biochemical results you may expect in secondary hyperparathyroidism
(Ca2+, alk phos, phosphate and PTH level)
High PTH
High phosphate (due to kidney disease)
Low calcium (in response to high PTH)
Normal alk phos
Suggest what biochemical results you may expect in tertiary hyperparathryoidism
(Ca2+, phosphate and PTH level)
High PTH
High calcium
High phosphate (kidney disease)
Suggest what biochemical results you may expect in hypoparathyroidism
(Ca2+, alk phos, phosphate and PTH level)
Low PTH
Low calcium
Normal or low phosphate
Normal alk phos
Low Ca2+, low PTH, low phosphate, normal alk phos
Hypoparathyroidism
Suggest what biochemical results you may expect in pseudohypoparathyroidism
(Ca2+, alk phos, phosphate and PTH level)
High PTH
Low calcium
Normal alk phos
High PTH plus phenotype
Suggest what biochemical results you may expect in pseudo-pseudohypoparathyroidism
(Ca2+, alk phos, phosphate and PTH level)
Normal biochem, but phenotype of pseudohypoparathyroidism
Suggest what biochemical results you may expect in Paget’s disease
(Ca2+, alk phos, phosphate and PTH level)
Normal calcium (may be high after a period of inactivity) and phosphate
High alk phos.
PTH normal
Suggest what biochemical results you may expect in osteomalacia
(Ca2+, alk phos, phosphate and PTH level)
Low calcium
High PTH (reduced negative feedback from Ca2+)
High alk phos
Normal phosphate
Suggest what biochemical results you may expect in osteoporosis
(Ca2+, alk phos, phosphate and PTH level)
All results normal
Suggest what biochemical results you may expect in familial hypocalciuric hypercalcaemia
(Ca2+ and PTH level)
Low urine calcium
High serum calcium
Normal or high PTH
Low Na, High K
Addisons
High Na, Low K
Conns
Predicted Na and K levels in Addisons?
Low Na
High K
Predicted Na and K levels in Conns?
High Na
Low K
