Endocrine: Hyperparathyroidism (brief) Flashcards
what is primary Hyperparathyroidism?
overproduction of parathyroid hormone (PTH) produced directly by a tumour of the parathyroid glands
- leads to hypercalcemia
what is secondary Hyperparathyroidism?
overproduction of parathyroid hormone (PTH) due to insufficient vitamin D or chronic renal failure leads to low absorption of calcium from the intestines, kidneys and bones.
- leads to hypocalcaemia
what is tertiary Hyperparathyroidism?
This happen when secondary hyperparathyroidism continues for a long period of time.
- leads to hyperplasia of the glands
what are some risk factors for Hyperparathyroidism?
- female
- over 60 years
- family history
- multiple endocrine neoplasia
- Current or historical lithium treatment.
- Hyperparathyroidism-jaw tumour syndrome.
- History of head and neck radiation.
what signs may present on examination for a patient with Hyperparathyroidism?
- history of osteoporosis or osteopenia
- bone pain
- poor sleep
- fatigue
- anxiety, depression, memory loss
- muscle cramps
- constipation
- myalgia
what are some clinical features of Hyperparathyroidism?
- osteoporosis or osteopenia
- Bone pain.
- Poor sleep/fatigue.
- Anxiety, depression.
- Memory loss.
- Myalgias.
- Paraesthesias
- Muscle cramps.
- Constipation.
what is Paraesthesias?
an abnormal sensation, typically tingling or pricking (‘pins and needles’)
which conditions present in a similar way to Hyperparathyroidism?
Familial hypocalciuric hypercalaemia. Humoral hypercalcaemia of malignancy. Multiple myeloma. Milk-alkali syndrome. Sarcoidosis. Hypervitaminosis D. Thyrotoxicosis. Chronic or Acute leukaemia. Immobilisation. Thiazides.
what investigations would you do to confirm a diagnosis of Hyperparathyroidism?
- serum calcium (high)
- serum PTH (high)
NB secondary hyperparathyroidism may present with high PTH but normal/low calcium
what is the treatment of Hyperparathyroidism?
parathyroidectomy
Vit D supplementation ( ergocalciferol OR colecalciferol)
