General practice and primary healthcare

Question 1

Hyperparathyroidism

Answer 1

clinical condition resulting from the excessive secretion of parathyroid hormone (PTH).

Question 2

Primary Hyperparathyroidism (PHPT) aetiology

Answer 2

• parathyroid gland adenoma, hyperplasia of all four glands, or parathyroid carcinoma.

Question 3

Secondary Hyperparathyroidism (SHPT)

Answer 3

Typically due to vitamin D deficiency, loss of extracellular calcium, calcium malabsorption, abnormal parathyroid hormone activity, or inadequate calcium intake.

Question 4

Tertiary Hyperparathyroidism (THPT)

Answer 4

Occurs after prolonged secondary hyperparathyroidism due to conditions like chronic kidney disease.

Question 5

Hyperparathyroid signs and symptoms

Answer 5

• Moans: Painful bones
• Stones: Renal stones
• Groans: Gastrointestinal symptoms (nausea, vomiting, constipation, indigestion)
• Psychiatric Moans: Neurological effects (lethargy, fatigue, memory loss, psychosis, depression)

Question 6

Primary Hyperparathyroidism (PHPT) managment

Answer 6

Definitive management is parathyroidectomy.

Question 7

Secondary Hyperparathyroidism (SHPT) managment

Answer 7

Address underlying causes; vitamin D supplementation and phosphate binders may be needed.

Question 8

Tertiary Hyperparathyroidism (THPT) managment

Answer 8

Managed with medication like Cinacalcet, a calcimimetic that mimics the action of calcium on tissues, or via total or subtotal parathyroidectomy.

Question 9

Poorly controlled hypertension, already taking an ACE inhibitor and a thiazide diuretic

Answer 9

Add calcium channel blocker