hyperparathyroidism

Question 1

what produce parathyroid hormone

Answer 1

parathyroid glands (esp chief cells) in response to hypocalcaemia

Question 2

PTH raises blood calcium by

Answer 2

inc osteoclast acvitvity
inc Ca absorption from gut
inc Ca absorption from kidney
inc VitD activity

Question 3

symptoms of hypercalcaemia

Answer 3

renal stones, painful bones, abdo groans and psychiatric moans

Question 4

1ry hyperparathyroidism

Answer 4

uncontrolled PTH produced by tumour of PT gland

leads to hypercalcaemia

Question 5

1ry hyperparathyroidism Mx

Answer 5

surgical removal of tumour

Question 6

2ry hyperparathyroidism

Answer 6

insufficient VitD or CKD leads to low Ca absorption from intestine, kidneys + bones
leads to hypocalcaemia
PT glands react to low Ca by producing more PTH –> hyperplasia

Ca will be low or normal but PTH will be high

Question 7

2ry hyperparathyroidism Mx

Answer 7

correct vitD defieicny
or
renal transplant to treat renal failure

Question 8

3ry hyperparathyroidism

Answer 8

happens when 2ry hyperparathyroidism continues for long time
hyperplasia of glands and baseline PTH increases dramatically

hypercalcaemia

Question 9

3ry hyperparathyroidism Mx

Answer 9

surgically removing part of PT tissue to return PTH to good level

Question 10

PTH and Ca levels: primary

Answer 10

PTH high

calcium high

Question 11

PTH and Ca levels: secondary

Answer 11

PTH high

Calcium low/normal

Question 12

PTH and Ca levels: tertiary

Answer 12

PTH high

calcium high

Question 13

Mx if not suitable for surgery

Answer 13

cinacalcet a calcimimetic

Question 14

hypercalcaemia ECG change

Answer 14

shortened QT interval