Hyperparathyroidisim Flashcards
What are the key features of primary hyperparathyroidism on blood test?
HIGH calcium
Low phosphate
Normal PTH
What is the cause of primary HPT?
Parathyroid gland adenoma, carcinoma or hyperplasia of all 4 glands. It is definitely managed with parathyroidectomy.
What are the key features of secondary hyperparathyroidism on blood test?
Low calcium
HIGH phosphate
HIGH PTH
What is the cause for secondary hyperparathyoridism?
Strongly associated with CKD but occurs due to:
Vitamin D deficiency, loss of calcium, calcium malnutrition/malabsorption
Abnromal pTH activity
Managed with vitamin D supplementation or phosphate binders
What are the key features of tertiary hyperparathyroidism on blood test?
HIGH calcium
Low normal phosphate
HIGH pTH
What is the cause of tertiary hyperparathyroidism?
Most common cause is Chiron kidney disease, even after kidney transplants
Excess PTH secretion When secondary hyperparathyroidism is untreated for too long
How is tertiary hyperparathyoridism managed?
Cinacalcet which reduces PTH secretion and mimics actio of calcium on tissues
Parathyroidectomy
How does pseudohyperparathyoriim present?
Symptoms of hypocalcaemia lie unexplained muscle cramps and tingling tensation and Chvostek’s and Trousseau’s sign, HOWEVER PTH is high
What is the cause of pseudohypoparathyoridism?
Genetic disorder affecting GNAS1 gene
What are the key features on diagnosic tests for pseudohypoparathyoridism?
Hypocalcaemia
Normal or elevated PTH
What it’s he management of pseudohypoparathyoridism?
Calcium and Vitamin D supplementation
