Hyperparathyroidism Flashcards
What cells in the parathyroid glands produce PTH?
chief cells
List 4 actions of PTH
- ↑ osteoclast activity
- ↑ Ca2+ absorption from gut
- ↑ Ca2+ absorption from kidneys
- ↑ vitamin D activity
Relationship between PTH and Vitamin D?
PTH acts on Vit D to convert it into active forms
Action of Vit D?
Increases calcium absorption from the intestines
List 4 symptoms of hypercalcaemia
‘stones, moans and groans’
- Renal stones
- Painful bones
- Abdominal groans → constipation, nausea and vomiting
- Psychiatric moans → fatigue, depression and psychosis
What is primary hyperparathyroidism?
Caused by uncontrolled PTH due to a tumour of the parathyroid glands
Treatment of primary hyperparathyroidism?
Surgery
What is secondary hyperparathyroidism?
- Insufficient Vit D or CKD leads to low absorption of Ca2+ from intestines, kidneys and bones
- Parathyroid glands reacts by secreting more PTH
- Over time this leads to hyperplasia
Treatment of secondary hyperparathyroidism
- Correcting the vitamin D deficiency OR
- Renal transplant for CKD
What is tertiary hyperparathyroidism?
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
What is the most likely diagnosis:
- High PTH
- High Calcium
- Primary hyperparathyroidism (tumour) OR
- Tertiary hyperparathyroidism (hyperplasia)
What is the most likely diagnosis:
- High PTH,
- Low/ Normal Calcium
Secondary hyperparathyroidism (Low Vit D or CKD)