Hyperparathyroidism Flashcards
What is it?
Over-active parathyroid glands due to excess production of PTH
What does it do?
Causes serum calcium levels to rise and serum phosphate levels to fall-Pulls the calcium out of bone and puts phosphate in
What is the cause of Primary?
Primary Adenoma or Gland hyperplasia producing too much PTH (high calcium, high PTH)
What is the cause of secondary?
Increased PTH production due to low calcium due to kidney liver or bowel disease (low calcium, high PTH)
What is the cause of tertiary?
Autonomous secretion of PTH due to chronic kidney disease (high calcium, high PTH)
What is malignant hyperparathyroidism?
Parathyroid related hormone is released by Squamous Cell Lung cancers, breast and renal carcinomas causing high calcium and low PTH
Is hyperparathyroidism common?
Primary is 3rd most common endocrine disorder, the others are less common
Who does it affect?
Usually post-menopausal women
Signs and Symptoms of Primary (14)
Bone pain, abdo pain, depression, osteoporosis, renal calculi, muscle wasting, fatigue, anorexia, nausea, vomiting, polyuria, polydipsia, dehydration, hypertension
Signs and Symptoms of Secondary
Osteomalacia due to low vitamin D, symptoms of chronic kidney disease
Signs and symptoms of Tertiary
Similar to primary
What bloods would you do? (9)
FBC, U&E, LFT, CRP, TFT, PTH, Calcium, vit D, phosphate
Other investigations (2)
DEXA Scan, imaging of renal tract
What is the treatment for primary? (5)
Remove the adenoma, Vitamin D supplements, maintain hydration, avoid thiazide diuretics, HRT and raloxifene to reduce Ca2+
What is the treatment for secondary? (4)
Manage renal impairment, Calcium supplements, vitamin d supplements, phosphate restriction
