hyperparathyroidism Flashcards
what produces PTH
cheif cells in parathroid glands in response to hypocalcaemia
how does PTH raise blood calcium
- inc osteoclast activity
- inc Ca absorption rom gut
- inc Ca absorption from kidneys
- convert vitamin D to active form
hw does vitamin D raise blood calcium
increase calcium absorption from the interstines
symptoms of hypercalcaemia
stones, bones, groans and psychic moans
- renal stones
- painful bones
- constipation, N+V
- depression, fatigeu, psychosis
primary hyperparathyroidism
uncontrolled PTH directly by tumour of parathyroid gland
leads to hypercalcaemiA
how is 1ry hyperparathyroidism treated
total parathyroidectomy
2ry hyperparathyroidism
insufficienct vitD or CKD leads to low absorotion of calcium from intestines, kidneys an dbones
what does 2ry hyperparathyroid result in
- reduced ca absorption –> hypocalcaemia
- react to low Ca by excreting more PTH –> parathyroid gland hyperplasia
- serum calcium be low/normal but PTH be high
2ry hyperparathyroidism Mx
correct vit d deficiency
renal transplant to treat renal failure
3ry hyperparathyroidism
when 2ry happens for a long time –>hyperplasia of glands
when cause of 2ry treated, PTH remains innaprop high –> hypercalcaemia
3ry hyperparathyroidim Mx
surgically remove part of parathyroid tissue to return PTH to approp levels
PTH and Calcium levels: 1ry hyperparathyroidism
pth high
calcium high
PTH and Calcium levels: 2ry hyperparathyroidism
PTH high
calcium low/normal
PTH and Calcium levels: 3ry hyperparathyroidism
pth high
calcium high
