Hyperparathyroidism

Question 1

What is the presentation of Hyperparathyroidism?

Answer 1

Stones - renal stones
Bones - Pain and pathological #'s
Moans - Depression
Groans - Pancreatitis, Abdominal pain, n+v, constipation
Increased BP

Question 2

What is the action of Parathyroid hormone?

Answer 2

Released when Ca2+ low
Stimulates osteoclasts
Inhibits osteoblasts
Increases Ca2+ reabsorption in the kidney
Decreases phosphate reabsorption in kidney
Increases 1α-hydroxylation of calciferol to calcitriol

Question 3

What are the causes of Primary Hyperparathyroidism?

Answer 3

Adenoma
Hyperplasia
Has high Ca2+

Question 4

What are the causes of Secondary Hyperparathyroidism?

Answer 4

Vitamin D deficiency
Chronic renal failure
Has high PTH, low Ca2+ and vit D, high PO4

Question 5

What is the management of Primary Hyperparathyroidism?

Answer 5

Increased fluid intake
Decrease dietary Ca2+
Avoid Thiazides as they increase Ca2+
May resect adenoma

Question 6

What is the management of Secondary Hyperparathyroidism?

Answer 6

Treats causes
Phosphate binders
Give vit D eg calcitriol

Question 7

What is Tertiary Hyperparathyroidism?

Answer 7

Prolonged secondary HPT, PTH secreted at excessive rate
High Ca2+
Low PO4
Complication of CKD
Treat same as Secondary but without PO4 binders