Hyperparathyroidism

Question 1

Most common cause of hyperparathyroidism

Answer 1

85% solitary adenoma
10% hyperplasia

Question 2

Symptoms of hyperparathyroidism

Answer 2

polydipsia, polyuria
depression
anorexia, nausea, constipation
peptic ulceration
pancreatitis
bone pain/fracture
renal stones
hypertension

Question 3

Management of hyperparathyroidism

Answer 3

Surgery to remove parathyroid gland

If patient not suitable then may be able to give cinacalcet

Question 4

MOA cinacalcet

Answer 4

A calcimimetic ‘mimics’ the action of calcium on tissues by allosteric activation of the calcium-sensing receptor

Question 5

Primary parathyroid bloods

Answer 5

Raised calcium
Raised/normal PTH
Raised vitamin D
Low phosphate

Question 6

Secondary hyperparathyroid cause

Answer 6

Low vitamin D

Question 7

Secondary hyperparathyroid bloods

Answer 7

Raised PTH
Raised Ca
Low vitamin D
Normal/low phosphate

Question 8

Tertiary hyperparathyroid cause

Answer 8

CKD

Question 9

Tertiary hyperparathyroid bloods

Answer 9

Raised everything

Question 10

Pseudohypoparathyroidism

Answer 10

When the body cannot respond to PTH therefore presents like hypocalcaemia (numbness and tingling) and hyperphosphataemia

Question 11

Pseudopseudohypoparathyroidism

Answer 11

An inherited condition that causes short stature, round face, and short hand bones