Hyperparathyroidism

Question 1

Primary Hyperparathyroidism
1. Incidence
2. Age
3. Sex
4. Pathogenesis
5. Dx
6. Tx

Answer 1

1. 1 in 400 to 1,000
2. 40-60 y/o
3. Female:male = 3:1
4. Oversecretion of PTh – skeleton and kidneys
   Loss of bone mass in sites rich in cortical bone
5. Dx: increased serum intact PTh in a patient with hypercalcemia
6. Tx: surgical removal of the parathyroid adenoma or carcinoma

Question 2

Secondary Hyperparathyroidism
1. Common or not?
2. May cause enough bone loss? Yes or No?
3. Causes
4. Tx

Answer 2

1. Common
2. May cause enough bone loss
3. Vit D deficiency,
   low dietary Ca++,
   glucocorticoid therapy,
   fat malabsorption,
   loop diuretic therapy,
   renal insufficiency
4. Tx: Ca supplements, Vit D replacement

Question 3

Role of Parathyroid Glands

Answer 3

1. Bones- release calcium
2. Kidneys- reduce calcium clearance and vitamin D activation.
3. Intestines- Activated vitamin D helps absorb calcium in gut

Question 4

The major function of PTH and major physiologic regulator is _________

Answer 4

Ciculating Ionized Calcium

Question 5

1. Optimal vitamin D levels are necessary to increase the efficiency of calcium absorption.
2. Without adequate vitamin D, the body absorbs no more than 10% to 15% of dietary calcium.
3. In the vitamin D–sufficient state, the intestinal calcium absorption increases to 30% to 40%.

Answer 5

Oki