Hyperparathyroidism Flashcards
1
Q
What is primary hyperparathyroidism?
A
Primary overactivity of parathyroid gland (eg an adenoma)
2
Q
What is secondary hyperparathyroidism?
A
A physiological response to low calcium or vitamin D causing high PTH
3
Q
What is tertiary hyperparathyroidism?
A
The parathyroid becomes autonomous after many years of overactivity (eg renal failure)
4
Q
Causes of hyperparathyroidism?
A
- MEN 1/2: Will almost always have developed a parathyroid adenoma with hypercalcaemia at a young age
- Familial isolated hyperparathyroidism: an adenoma as in primary hyperparathyroidism and managed in the same way
5
Q
How is primary hyperparathyroidism investigated?
A
- High calcium and high PTH
- Raised serum calcium and raised PTH
- Increased urine calcium excretion
6
Q
Secondary hyperparathyroidism investigation?
A
Low calcium and high PTH
7
Q
Tertiary hyperparathyroidism investigation?
A
High calcium and high PTH
8
Q
Medical treatment of primary hyperparathyroidism?
A
CINACALCET
- Calcium mimetic
- Approved for tertiary hyperparathyroidism and parathyroid carcinoma
9
Q
Surgical treatment of primary hyperparathyroidism?
A
NOT always needed by parathyroidectomy indicated when:
- Bone disease
- Gastric ulcers
- Renal stones
- Osteoporosis
- High calcium > 2.85mmol/L
- Primary hyperparathyroidism before 50
