Hyper/Hypoparathyroidism

Question 1

Where is PTH made and what affect does it have?

Answer 1

PTH is made in the parathyroid gland, it increases osteoclast break down of bone and release of Calcium

Increases absorption from the GIT and kidney

Question 2

What is primary hyperparathyroidism and what levels can you expect?

Answer 2

PTH is secreted in mass usually by a parathyroid tumour.

PTH will be normal or high, calcium will be normal or high. Vit D will likely be normal

Question 3

What is secondary hyperparathyroidism and what levels can you expect?

Answer 3

Where low Vitamin D or kidney disease cause less reabsorption of calcium.

PTH is high, Calcium is low, Vit D is normal or low

Overtime if left untreated parathyroid hyperplasia will occur

Question 4

What is tertiary hyperparathyroidism?

Answer 4

where secondary disease is left untreated and parathyroid hyperplasia occurs causing lots of PTH.

Often when secondary disease os treated becomes apparent

PTH + calcium are high ++

Question 5

What are the main causes of hypoparathyroidism?

Answer 5

Surgical resection
Congenital absence (DiGeorge syndrome)
Autoimmune
Magnesium defiency

Question 6

What blood levels do we expect in hypoparathyroidism?

Answer 6

PTH low, Calcium low
Phosphate HIGH

Question 7

How do we treat hypothyroidism?

Answer 7

Calcium + vit d replacement
Low phosphorus diet