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Year3 Endo Conditions > Hypoparathyroidism > Flashcards

Hypoparathyroidism Flashcards

1
Q

What is hypoparathyroidism?

A

caused by relative or absolute deficiency of plasma parathyroid hormone (PTH) synthesis and secretion

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2
Q

What is primary hypoparathyroidism?

A

PTH secretion is low due to gland failure

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3
Q

What are the causes of primary hypoparathyroidism?

A
  1. Autoimmune

2. Congenital

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4
Q

What are causes of secondary hypoparathyroidism?

A
  1. Radiation
  2. Surgery (thyroidectomy, parathyroidectomy)
  3. Hypomagnesaemia (magnesium is required for OTH secretion)
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5
Q

What is pseudohypoparathyroidism?

A
  • failure of target cell response to PTH

- genetic cause

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6
Q

What are the signs of psuedohypoparathyroidism?

A
  1. Short metacarpals
  2. Round face
  3. Short stature
  4. Calcified basal ganglia
  5. Low IQ
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7
Q

What do tests show for psudeoparathyroidism?

A
  1. Low calcium
  2. High PTH
  3. High or normal ALP
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8
Q

How do you treat psuedohypoparathyroidism?

A

same as primary hypothyroidism

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9
Q

What is pseudopseudohypoparathyroidism?

A
  1. morphological features of pseudohypoparathyroidism with normal biochem
  2. cause is genetic
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10
Q

What are RF for hypoparathyroidism?

A
  1. Thyroid surgery, Parathyroid surgery
  2. Chronic alcoholism
  3. Hypomagensaemia
  4. Moderate and chronic maternal hypercalcaemia (neonatal hypocalcaemia)
  5. Autosomal dominant conditions (e.g. mutations in CASR, GATA3)
  6. Hereditary haemochromatosis
  7. Transfusional iron overload in thalassaemia
  8. Metastatic cancer
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11
Q

What are symptoms of hypoparathyroidism?

A
  1. Muscle twitches, spasms and cramps: due to hypocalcaemia!
  2. Paraesthesia, numbness, tingling
  3. Poor memory, slowed thinking
  4. Convulsions
  5. Anxiety
  6. Dry hair, brittle nails
  7. Cataracts
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12
Q

What are signs of hypoparathyroidism?

A
  1. Chvostek’ sign
  2. Trousseau sign
  3. Irregular heart beat, tachycardia
  4. Laryngeal spasm (uncommon)
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13
Q

What are possible differential diagnosis of hypoparathyroidism?

A
  1. Hypovitaminosis D
  2. Hypomagnesaemia
  3. Hypoalbuminemia
  4. Pseudohypoparathyroidism
  5. Renal failure, chronic kidney disease
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14
Q

What are possible complications of hypoparathyroidism?

A
  1. Ectopic calcifications
  2. Cataract
  3. Hypercalcaemia
  4. Renal insufficiency
  5. Renal stones
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15
Q

What investigations do you do for hypoparathyroidism?

A
  1. Serum calcium
  2. Phosphate
  3. ALP
  4. serum albumi
  5. ECG: prolonged QT interval
  6. plasma intact PTH
  7. serum magnesium
  8. serum 25-hydroxyvitamin D
  9. serum phosphorus
  10. serum creatinine
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16
Q

What is serum calcium like in hypoparathyroidism?

A

low

17
Q

What are phosphate levels like in hypoparathyroidism?

A

high

18
Q

What are ALP levels in hypoparathyroidism?

A

normal

19
Q

What are serum albumin levels like in hypoparathyroidism?

A

normal, a low albumin will give falsely low total serum calcium

20
Q

What does an ECG show in hypoparathyroidism?

A

Prolonged QT interval

21
Q

What is serum intact PTH level like in hypoparathyroidism?

A

low or normal

22
Q

What is serum magnesium like in hypoparathyroidism?

A

low

23
Q

What would serum 25-hydroxyvitamin D be like in hypoparathyroidism?

A

low

24
Q

What would serum phosphorus be like in hypoparathyroidism?

A

usually elevated

25
Q

What is the treatment for hypoparathyroidism?

A

Ca2+ supplements (calcium carbonate) + calcitrol

26
Q

What is the treatment for hypoparathyroidism if severe?

A
  • IV calcium

- With hypomagnesaemia: magnesium sulfate 1g IV every 6 hours

Year3 Endo Conditions (33 decks)

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