Hypoparathyroidism

Question 1

What is primary hypoparathyroidism

Answer 1

decrease in PTH secretion
leading to low calcium and high phosophate

Question 2

What are the main symptoms of hypoparathyroidism

Answer 2

they are all secondary to hypocalcaemia

-tetany
-perioral paraesthesia
-if chornis - depression, cataracts

Question 3

What is seen on an ECG in someone with hypoparathyroidism

Answer 3

prolonged QT interval

Question 4

What 2 signs are associated with hypoparathyroidism

Answer 4

Trousseau’s sign- carpal spasm

chovsteks sign - tapping over parotid causes facial muscles to twitch

Question 5

What investigations are needed

Answer 5

bloods- serum calcium, phosphate, PTH and ALP

will usually demonstrate low calcium , elevated phosphate, decreased PTH and a normal ALP

Question 6

What is management of hypoparathyroidism

Answer 6

if severe hypocalcemia - administer IV calcium gluconate

administer calcium and vitamin D replacement
-ALFACALCIDOL

Question 7

What is pseudohypoparathyroidism

Answer 7

target cells being insensitive to PTH
due to abnormality in a G protein

Question 8

What symptoms are pseudohypoparathyroidism associated with

Answer 8

low IQ, short stature, shortened 4th and 5th metacarpals

Question 9

What would seen on blood test for someone with pseudohypoparathyroidism

Answer 9

low calcium , high phosphate , high PTH

Question 10

How do you make diagnosis of someone with pseudohypoparathyroidism

Answer 10

measure urinary cAMP and phosphate levels following an infusion of PTH

in normal hypoparathyroidism will cause increase in both cAMP and phosphate levels

in pseudohypoparathyroidism type 1 neither cAMP nor phosphate levels increase

in pseudohypoparathyroidism
type 2 only cAMP rises