Hyperparathyroidism Flashcards

1
Q

What cells in the parathyroid glands produce PTH?

A

chief cells

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2
Q

List 4 actions of PTH

A
  1. ↑ osteoclast activity
  2. ↑ Ca2+ absorption from gut
  3. ↑ Ca2+ absorption from kidneys
  4. ↑ vitamin D activity
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3
Q

Relationship between PTH and Vitamin D?

A

PTH acts on Vit D to convert it into active forms

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4
Q

Action of Vit D?

A

Increases calcium absorption from the intestines

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5
Q

List 4 symptoms of hypercalcaemia

‘stones, moans and groans’

A
  1. Renal stones
  2. Painful bones
  3. Abdominal groans → constipation, nausea and vomiting
  4. Psychiatric moans → fatigue, depression and psychosis
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6
Q

What is primary hyperparathyroidism?

A

Caused by uncontrolled PTH due to a tumour of the parathyroid glands

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7
Q

Treatment of primary hyperparathyroidism?

A

Surgery

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8
Q

What is secondary hyperparathyroidism?

A
  1. Insufficient Vit D or CKD leads to low absorption of Ca2+ from intestines, kidneys and bones
  2. Parathyroid glands reacts by secreting more PTH
  3. Over time this leads to hyperplasia
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9
Q

Treatment of secondary hyperparathyroidism

A
  1. Correcting the vitamin D deficiency OR
  2. Renal transplant for CKD
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10
Q

What is tertiary hyperparathyroidism?

A

Due to hyperplasia of the gland as a result of long term secondary hyperparathyroidism

  • Baseline levels of PTH increase dramatically
  • Even when cause is treated, PTH levels remain high → hypercalcaemia
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11
Q

What is the most likely diagnosis:

  • High PTH
  • High Calcium
A
  1. Primary hyperparathyroidism (tumour) OR
  2. Tertiary hyperparathyroidism (hyperplasia)
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12
Q

What is the most likely diagnosis:

  • High PTH,
  • Low/ Normal Calcium
A

Secondary hyperparathyroidism (Low Vit D or CKD)

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