Hyperparathyroidism, Renal dystrophy and Paget's Disease

Question 1

What is hyperparathyroidism?

Answer 1

Overactivity of the parathyroid glands resulting in increased levels of PTH

Question 2

What are the primary causes of hyperparathyroidism?

Answer 2

benign adenoma, hyperplasia or a malignant neoplasia

Question 3

What does hyperparathyroidism result in?

Answer 3

hypercalcaemia

Question 4

What biochemical signs would you see in hyperparathyroidism?

Answer 4

increased serum PTH, increased calcium, normal or low phosphate

Question 5

What causes secondary hyperparathyroidism?

Answer 5

Physiological, due to a deficiency of vitamin D or CKD

Question 6

What causes tertiary hyperparathyroidism?

Answer 6

Having secondary hyperparathyroidism and an adenoma

Question 7

What is renal dystrophy?

Answer 7

bone changes due to CKD

Question 8

What causes renal dystrophy?

Answer 8

reduced phosphate excretion or inactive activation of vitamin D

Question 9

What happens due to renal dystrophy?

Answer 9

hyperparathyroidism and subsequent Osteomalacia, sclerosis of bone and calcification of soft tissue

Question 10

Is Paget’s disease acute or chronic?

Answer 10

Chronic

Question 11

What happens in Paget’s disease?

Answer 11

thickened, brittle and misshapen bones

Question 12

How many bones does Paget’s disease affect?

Answer 12

one or a few bones

Question 13

What percentage of 55+ people are affected by Paget’s disease?

Answer 13

4%

Question 14

What percentage of 80+ people are affected by Paget’s disease?

Answer 14

10%

Question 15

What causes Paget’s disease

Answer 15

viral infection, genetic defects

Question 16

What is the pathogenesis behind Paget’s disease?

Answer 16

increased osteoclast activity leading to increased bone turnover. Osteoblast activity then increases to keep up and the new bone isn’t properly remodelled

Question 17

What bones are affected by Paget’s disease?

Answer 17

Pelvis, femur, skull, tibia and ear ossicles

Question 18

Can Paget’s disease be asymptomatic?

Answer 18

yes

Question 19

If there are symptoms for Paget’s disease, what are they?

Answer 19

Arthritis, fracture, deformity, pain and cardiac output failure

Question 20

How do you treat Paget’s disease?

Answer 20

bisphosphonates, calcitonin, replace the joint and stabilise fractures