Hyperparathyroidism Flashcards
link between calcium levels and parathyroid hormone
low calcium levels increase the secretion of PTH, high levels inhibit PTH release
What is the effect of PTH on calcium levels and how
PTH increases the serum calcium by activating osteoclast activity, releasing calcium from bones
three stages of hyperparathyroidism
primary- increased release of PTH UNRELATED to calcium levels
secondary- increased release of PTH due to low serum calcium
tertiary- autonomous PTH release due to chronic secondary hyperparathyroidism
common causes of primary hyperparathyroidism
parathyroid gland adenoma
parathyroid hyperplasia
parathyroid carcinoma
inherited diseases such as MEN (multiple endocrine neoplasia)
common causes of secondary hyperparathyroidism
chronic renal failure and Vitamin D deficiency
the kidneys can’t make vitamin D in CKD and therefore the reabsorption of calcium is limited… leading to low serum calcium and therefore PTH secretion increases as a result
risk factors of developing hyperparathyroidism
genetics, MEN, lithium treatment,
why can lithium treatment increase the risk of hyperparathyroidism
lithium drugs can damage the kidneys and if the kidneys can’t produce vitamin D, a deficiency in Vitamin D can lead to low serum calcium and therefore PTH secretion is unregulated
investigations for hyperparathyroidism
PTH levels, serum calcium (usually will be high)
what main symptoms do people with hyperparathyroid present with
if they have mild Hypercalcaemia, they may be asymptomatic
with Hypercalcaemia, symptoms may include;
polyuria, polydipsia, fatigue, fever, malaise, kidney stones, bone/joint pain, nausea, constipation weakness, cramping and muscle spasms
treatment of hyperparathyroidism
parathyroidectomy (if possible) with vitamin D supplementation
OR
bisphosphonates with Vitamin D supplementation
prognosis of hyperparathyroidism
parathyroidectomy is curative in 95% of cases
complications of hyperparathyroidism
increased bone resorption
