Hyperparathyroidism Flashcards

1
Q

what is the hormone profile in primary hyperparathyroidism?

A
  • PTH = elevated
  • Ca2+ = elevated
  • phosphate = low
  • urine calcium : creatinine clearance ratio >0.01
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2
Q

what are the clinical features of primary hyperparathyroidism?

A
  • can be asymptomatic
  • recurrent abdominal pain
  • changes to emotional or cognitive state
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3
Q

what are the causes of primary hyperparathyroidism?

A

parathyroid pathology
* solitary adenoma (80%)
* multifocal disease
* parathyroid carcinoma

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4
Q

what is the most common cause of primary hyperparathyroidism?

A

solitary adenoma

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5
Q

what is the hormone profile in secondary hyperparathyroidism?

A
  • PTH = elevated
  • Ca2+ = low or normal
  • phosphate = elevated
  • vitamin D = low
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6
Q

what are the clinical features of secondary hyperparathyroidism?

A

may have few symptoms. will eventually develop:
* bone disease
* osteitis fibrosa cystica
* soft tissue calcifications

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7
Q

what is the pathophysiology of secondary hyperparathyroidism?

A
  1. insufficient **vitamin D **or chronic renal failure
  2. low absorption of calcium from the intestines, kidneys and bones
  3. causes hypocalcaemia
  4. parathyroid excretes more PTH
  5. resulting **parathyroid hyperplasia **
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8
Q

what is the most common cause of secondary hyperparathyroidism?

A

chronic renal failure

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9
Q

what is the hormonal profile of teritary hyperparathyroidism?

A
  • PTH = elevated
  • Ca2+ = normal or high
  • phosphate = low or normal
  • vitamin D = low or normal
  • alkaline phosphate = elevated
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10
Q

what are the clinical features of tertiary hyperparathyroidism?

A
  • metastatic calcification
  • bone pain and/or fracture
  • nephrolithiasis
  • pancreatitis
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11
Q

what is the pathophysiology of tertiary hyperparathyroidism?

A

result of ongoing hyperplasia of the parathyroid glands after correction of underlying renal disorder

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12
Q

what are the symptoms of hypercalcaemia?

A
  • renal stones
  • painful bones
  • abdominal groans - constipation, nausea, vomiting
  • psychiatric moans - fatigue, depression, psychosis
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13
Q

how is primary hyperparathyroidism managed?

A

surgically removing the tumour

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14
Q

how is secondary hyperparathyroidism managed?

A
  • correcting the vitamin D deficiency
  • performing renal transplant to treat renal failure
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15
Q

how is tertiary hyperparathyroidism managed?

A

surgically removing part of the parathyroid tissue to return the parathyroid hormone to an appropriate level

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