Hyperparathyroidism Flashcards
What are the main causes of hyperparathyroidism?
Solitary adenoma (80%)
Hyperplasia of the gland
How does hyperparathyroidism present?
Symptoms of hypercalcaemia
What are the symptoms of hypercalcaemia?
‘bones, stones, abdominal groans and psychic moans’
polydipsia, polyuria
peptic ulceration/constipation/pancreatitis
bone pain/fracture
renal stones
depression
hypertension
How is hyperparathyroidism diagnosed?
Raised Calcium
Raised PTH
Low Phosphate
What would you use to diagnose primary hyperparathyroidism?
Bloods- raised calcium, low phosphate
X-ray- Pepper pot skull
What would you find on an x-ray of someone with Hyperparathyroidism?
Pepper pot skull
What is the surgical management of hyperparathyroidism?
Parathyroidectomy
What is the medical management of hyperparathyroidism?
Bisphosphonates
What are the 2 main causes of secondary hyperparathyroidism?
- Vit D deficiency
- Chronic Renal Failure
How does secondary hypoparathyroidism present?
- Symptoms of hypocalcaemia
* Hyperplasia of the gland-gets bulky
What are symptoms of hypocalcaemia?
SPASMODICS
How would you diagnose secondary hyperparathyroidism?
Raised ALP
Raised PTH and phosphate
Low calcium
What is the surgical management of secondary hyperparathyroidism?
Parathyroidectom
What is the medical management of secondary hypoparathyroidism?
Cinacalcet
What is tertiary hyperparathyroidism?
Secondary hyperparathyroidism continues for a long period of time
How does tertiary hyperparathyroidism present?
PTH remains inappropriately high
High calcium
High PTH
What is the management of hyperparathyroidism?
Parathyroidectomy
What can patients who aren’t suitable for surgery be given?
cinacalce
What is cinacalce?
a calcimimetic- ‘mimics’ the action of calcium on tissues
What is primary hyperparathyroidism associated with?
hypertension
multiple endocrine neoplasia: MEN I and II
What is secondary hyperparathyroidism a result of?
Increased secretion of PTH in response to low calcium due to kidney, liver or bowel disease
What is tertiary hyperparathyroidism due to?
Usually occurs after prolonged secondary hyperparathyroidism- autonomous secretion of PTH, usually because of chronic kidney disease (CK
What is hyperparathyroidism due to?
Excess secretion of PTH resulting in hypercalcaemia
How can the PTH be affected in primary hyperparathyroidism?
Normal or raised
