Hypoparathyroidism Flashcards
What is Primary Hypoparathyroidism?
A reduction in PTH secretion, secondary to Thyroid Surgery resulting in low Calcium and high Phosphate, treated with Alfacalcidiol.
Clinical Features of Hypoparathyroidism (6).
SECONDARY TO HYPOCALCAEMIA :
- Tetany.
- Perioral Paraesthesia.
- Trousseau’s Sign.
- Chvostek’s Sign.
- Chronic : Depression, Cataracts.
- ECG : Prolonged QT Interval.
What is Tetany?
Muscle Twitching, Cramping and Spasm.
What is Trousseau’s Sign?
Carpopedal spasm if the brachial artery is occluded by inflating the blood pressure cuff and maintaining pressure above the systolic pressure = wrist flexion and fingers are drawn together.
What is Chvostek’s Sign?
Tapping over the parotid (facial nerve) causes facial muscles to twitch.
What is Pseudohypoparathyroidism?
A rare genetic condition where target cells are insensitive to PTH due to an abnormality in a G protein.
How does Pseudhypoparathyroidism present?
- Low IQ.
- Short Stature.
- Shortened 3rd/4th Metacarpals.
- Low Calcium, High Phosphate, High PTH.
How is Pseudohypoparathyroidism diagnosed (2)?
Urinary cAMP and Phosphate levels following an infusion of PTH :
- Hypoparathyroidism : Increase in cAMP and Phosphate.
- Pseudohypoparathyroidism : No Rise.
Aetiology of Hypocalcaemia.
- Vitamin D Deficiency - Osteomalacia.
- CKD.
- Hypo/Pseudohypoparathyroidism.
- Rhabdomyolysis.
- Magnesium Deficiency.
- Massive Blood Transfusion.
- Acute Pancreatitis.
Management of Severe Hypocalcaemia.
- IV Replacement Calcium Gluconate 10ml - 10% Solution over 10 Minutes.
- ECG Monitoring.
- IV Calcium Chloride - Local Irritation.
What is Hypocalcaemia?
Circulating serum Calcium levels are below 2.1 mmol/L.
Management of Mild Hypocalcaemia.
Oral Calcium Supplementation.
