Hyperparathyroid Flashcards
Clinical Features
Bone pain, fragility fractures, ↓BMD
Nephrolithiasis, Nephrocalcinosis, polyuria, renal insufficiency
Nausea, Vomiting, PUD, constipation, pancreatitis
Lethargy, decreased cognition, depressed mood, psychosis, coma
Gout, pseudo gout
LV Hypertrophy, ↓QT interval
DDx
Vit D Deficiency
Chronic Renal Insufficiency
TSH
Malignancy
Adrenal Insufficiency
Risk Factors
Age > 50
F > M
Meds: Thiazide, Lithium
Radiation to neck, radioactive iodine
Genetic: MEN Type 1 + Type 2A, Familial Hypocalciuric Hypercalcemia, Familial Hyperparathyroidism – jaw tumor syndrome, Neonate severe hyperparathyroidism, Familial isolated hyperparathyroidism
Investigations
PTH
Ca
Albumin
Management of Primary Hyperparathyroidism
Volume Repletion
Loop Diuretics once euvolemic
Pamidronate or Zolindronate
Parathyroidectomy