Hyperparathyroidism Flashcards
What is hyperparathyroidism
Excessive production of PTH
What are the types of Hyperparathyroidism
Primary - 1+ glands produce excess PTH (Asymptomatic/hypercalcemia)
Secondary - kidney/liver disease causes Hypocalcemia so increase PTH release
Tertiary - CKD causes autonomous PTH release
What are the cause of Primary Hyperparathyrodisim
PTH adenoma
PTH Hyperplasia
Double Adenoma
PTH carcinoma
What are the signs of hypercalcemia
Moans (depression and lethargy)
Stones (renal stones)
Groans (GI SYMPTOMS)
Bones (Painful)
What are the causes of Secondary Hyperparathyroidism
Vitamin D deficient Hypocalcemia -Pancreatitis -Rhabdomyolysis Abnormal PTH -CKD -Pseudohypoparathyroidism
What are the causes of tertiary Hyperparathyroidsim
Prolonged Secondary causing PTH gland to be autonomous (CKD)
What is the management for hyperparathyroidism
Parathroidectomy
What are the risk factors for Hyperparathyroid
Neck Radiation
Family history
Work in nucleur power
What is the parathyroid
4 glands on the posterior aspect of the thyroid which is sensitive to calcium
What causes the release of parathyroid
Low calcium levels by Calcitonin negative feedback
Increases calcium levels
Where is calcitonin found
Parafollicular C cells of the Thyroid
What is the PTH action on bone
Increased bone resorption
- Allow RANK L Signalling
- Conver osteoblasts to osteoclasts
What malignancy can release PTH regardless of calcium levels
Neoplasms (SCLC, Breast and renal)
Are the levels of PTH and ALP in all types of hyperparathyroidism raised or reduced
Raised in all types for PTH and ALP
What are the levels of calcium in P/S and T Hyperparathyroidsim
P = High calcium S = Low calcium T = High calcium
What are the levels of Phosphate in P/S and T Hyperparathyroidsim
P = Low Phosphate S = High Phosphate T = High Phosphate
What are the diagnostic tests in Hyperparathyroidism
1st = Serum PTH/Ca/P/ALP
What investigations can be done for hyperparathyroidism
Serum PTH/Ca/P/ALP
Xray KUB - Renal stones
DEXA - Bone density
U+E - Renal function
What would an ECG show in hyperparthyroidism
Short QT (Hypercalcemia)
What is the main complication of hyperparathyroidism
Severe Hypercalcemia
-Give IV Fluid and Bisphosphonate
