Hyperparathyroidism Flashcards
Define hyperparathyroidism
Increased PTH production from the parathyroid glands, resulting in hypercalcaemia
describe primary hyperparathyroidism
Uncontrolled PTH release from a parathyroid tumour.
describe secondary hyperparathyroidism
Chronic Kidney Disease or insufficient Vitamin D results in decreased calcium absorption so more PTH is released to increase serum Calcium.
describe tertiary hyperparathyroidism
Continues from Secondary Hyperparathyroidism after an extended period. The parathyroid glands undergo hyperplasiaand are now accustomed to releasing high amounts of PTH, even after being treated.
what is a complication of hyperparathyroidism?
Acute Severe Hypercalcaemia
what are the risk factors for primary hyperparathyroidism? ( + epidemiology)
-Female
-Radiation therapy to the neck.
-Severe Vit D or Calcium deficiencies
-Familial Rare Conditions: MEN1 and 2A
describe the physiology behind PTH (what does increased PTH result in)
-Increased Calcium reabsorption
-Increased osteoclast activity
-Increased Vitamin D activity
-Decreased phosphate reabsorption
what investigations take place for hyperparathyroidism?
-Bloods
-DEXA Scan for bone density
-X-Ray to check for Kidney Stones
-U+E to assess renal function
-Short QT on ECG
what are the symptoms for hyperparathyroidism?
Bones – Excess resorption, osteopenia
Stones – Kidney Stones
Groans – Abdominal pain, constipation
Moans – Confusion, Anxiety
Thrones – Polyuria, Polydipsia
what are the symptoms for hyperparathyroidism the same as?
hypercalcaemia
what treatment is given for primary hyperparathyroidism?
– Surgically remove tumour
what treatment is given for secondary hyperparathyroidism?
– Treat underlying causes
what treatment is given for tertiary hyperparathyroidism?
– Surgically remove parathyroid tissue/glands
in primary hyperparathyroidism what would your PTH, Calcium, Phosphate and ALP look like?
PTH- high
calcium- very high
phosphate - LOW***
ALP- high
in secondary hyperparathyroidism what would your PTH, Calcium, Phosphate and ALP look like?
PTH- high
calcium- LOW**
phosphate - high
ALP- high