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Endocrine > Hyperparathyroidism > Flashcards

Hyperparathyroidism Flashcards

1
Q

What is hyperparathyroidism?

A

Endocrine disorder when the parathyroid glands become overactive and secrete too much PTH

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2
Q

What is primary hyperparathyroidism?

A

Hyperparathyroidism caused by problem within the parathyroid gland itself

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3
Q

Causes of primary hyperparathyroidism?

A

Parathyroid adenoma
Parathyroid carcinoma
Parathyroid hyperplasia

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4
Q

Bloods in primary hyperparathyroidism?

A

High Ca2+
High PTH
Low phosphate

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5
Q

Management of primary hyperparathyroidism?

A

Surgery

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6
Q

What is secondary hyperparathyroidism?

A

When disease outside of the parathyroid glands causes all of the parathyroid glands to become enlarged and hyperactive

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7
Q

Causes of secondary hyperparathyroidism?

A

Chronic renal failure

Vit D deficiency

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8
Q

Bloods in secondary hyperparathyroidism?

A

Low Ca2+
High PTH
High/normal phosphate

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9
Q

Management of secondary hyperparathyroidism?

A

Alfacalcidol (active form of vitamin D3 is 1,25-dihydroxy-vitamin D3)

Cinacalcet (calcium mimetic so negative feedback to parathyroids so lowers PTH)

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10
Q

What is tertiary hyperparathyroidism?

A

Long-standing secondary hyperparathyroidism which leads to the parathyroid gland becoming autonomous

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11
Q

Causes of tertiary hyperparathyroidism?

A

Long-standing chronic renal failure

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12
Q

Bloods in tertiary hyperparathyroidism?

A

High Ca2+
Very high PTH
High phosphate

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13
Q

Management of tertiary hyperparathyroidism?

A

Surgery - parathyroidectomy

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14
Q

Signs and symptoms of hypercalcaemia?

A

“Moans, stones, groans and bones”

Mood changes, joint pain and nausea and vomiting

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15
Q

Investigations for hypercalcaemia?

A

Bloods:
PTH
then Ca2+

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16
Q

Causes of hypercalcaemia?

A 
Hyperparathyroidism
Malignancy
Sarcoidosis
TB
Vit D intoxication
Addison's
Thiazide diuretics
17
Q

How is PTH used to diagnose the cause of hypercalcaemia?

A

Determines if the cause is due to hyperparathyroidism

Low PTH = malignancy
High PTH = hyperparathyroidism

18
Q

How is calcium then used to diagnose the cause of hyperparathyroidism?

A

High calcium = primary/tertiary hyperparathyroidism

Low calcium = secondary hyperparathyroidism

19
Q

How can we differentiate between primary and tertiary hyperparathyroidism?

A

Tertiary hyperparathyroidism has much more elevated PTH levels

20
Q

Initial treatment of hypercalcaemia?

A

IV saline 0.9%NaCL 1L over 4hrs (rehydration) + IV pamidronate if persistent

Then treat cause

Endocrine (9 decks)

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