Hyperparathyroidism Flashcards
What is hyperparathyroidism?
Hyperparathyroidism refers to elevated parathyroid hormone (PTH) levels.
Where are the parathyroid glands located and what do they do?
The parathyroid glands are located in four corners of the thyroid gland. They produce parathyroid hormone in response to low blood calcium (hypocalcaemia).
What are the actions of parathyroid hormone on the body?
Increases osteoclast activity in bones, releasing calcium.
Increases calcium reabsorption in the kidneys.
Increases vitamin D activity to enhance calcium absorption in the intestines.
How does vitamin D contribute to raising blood calcium levels?
Vitamin D increases calcium absorption in the intestines and works with parathyroid hormone to raise blood calcium levels by converting to its active form through the action of PTH.
What mnemonic is used to remember the symptoms of hypercalcaemia?
“Stones, bones, groans, and moans”:
* Kidney stones
* Painful bones
* Abdominal groans (constipation, nausea, vomiting)
* Psychiatric moans (fatigue, depression, psychosis)
What is primary hyperparathyroidism and its treatment?
Primary hyperparathyroidism is caused by a tumor in the parathyroid glands that leads to high parathyroid hormone and calcium levels. Treatment is surgical removal of the tumor.
What causes secondary hyperparathyroidism?
Secondary hyperparathyroidism is caused by low vitamin D or chronic kidney disease, leading to low calcium levels. The parathyroid glands compensate by producing more parathyroid hormone.
What is the treatment for secondary hyperparathyroidism?
The treatment involves correcting the underlying cause, such as vitamin D deficiency or chronic kidney disease, with possible interventions like renal transplant.
What is tertiary hyperparathyroidism?
Tertiary hyperparathyroidism occurs after long-standing secondary hyperparathyroidism. The parathyroid glands become hyperplastic and continue producing excessive parathyroid hormone even after the underlying cause is treated, leading to hypercalcaemia.
How is tertiary hyperparathyroidism treated?
Treatment involves surgically removing part of the parathyroid tissue to reduce excessive parathyroid hormone production.
What are the key differences between primary, secondary, and tertiary hyperparathyroidism?
Primary: Caused by a parathyroid tumor; high PTH and high calcium.
Secondary: Caused by low vitamin D or chronic kidney disease; high PTH and low/normal calcium.
Tertiary: Caused by long-standing secondary hyperparathyroidism; high PTH and high calcium.
