hypo- + hyper- parathyroidism

Question 1

primary hyperparathyroidism

Answer 1

caused by excess secretion of PTH resulting in hypercalcaemia

Question 2

causes of hyperparathyroidism

Answer 2

85% - solitary adenoma
10% - hyperplasia
4% - multiple adenoma
1% - carcinoma

Question 3

hyperparathyroidism xray findings

Answer 3

• “pepperpot skull”
• osteitis fibrosa cystica - formation of cyst like brown tumours around the bone

generalised osteopenia
loss of bone mass
calcified supporting structures are replaced with fibrous tissue

Question 4

primary hyperparathyroidism presentation

Answer 4

80% asymptomatic
hypercalcaemia;
- bones - pain/fractures
- stones - renal stones
- abdominal groans - anorexia, constipation
- psychic moans - depression

polyuria/dipsia

Question 5

conditions assoc with primary hyperparathyroidism

Answer 5

hypertension
MEN I + II

Question 6

primary hyperparathyroidism investigations

Answer 6

bloods
- raised calcium, LOW phosphate
- PTH raised or inappropriatley normal given raised calcium

technetium-MIBI subtraction scan

Xray ! - pepperpot skull!

Question 7

management of primary hyperparathyroidism

Answer 7

definitive = total parathyroidectomy

patients not suitable for surgery = cinacalcet
- a calcimimetic - mimics action of calcium on tissues