Hypoparathyroidism

Question 1

What happens in primary hypoparathyroidism?

Answer 1

decreased PTH secretion

low Ca2+ (less absorption) and high phosphate

Question 2

How does hypoPTH present?

Answer 2

Sx of hypocalcaemia:
- tetany - muscle twitching, cramping + spasm
- personal paraesthesia
- Trousseau’s sign - carpal spasm if the brachial artery occluded by inflating the BP cuff and maintaining pressure above systolic
- Chvosteks sign - tapping over parotid causes facial muscles to twitch
Chronic - depression, cataracts

Question 3

What can be seen on ECG in hypoparathyroidism?

Answer 3

prolonged QT interval

Question 4

What are the causes of primary hypoPTH?

Answer 4

Autoimmune

Congenital

Question 5

What is the rx of primary hypoPTH?

Answer 5

Ca2+ supplements

Calcitriol

Question 6

What are the causes of secondary hypoPTH?

Answer 6

radiation
surgery
hypomagnesaemia (magnesium required for PTH secretion)

Question 7

What is pseudohypoPTH?

Answer 7

target cells insensitive to PTH

Question 8

what is pseudohypoPTH associated w?

Answer 8

low IQ
Short stature
Shortened 4th and 5th metacarpals

Question 9

What levels of calcium, phosphate and PTH are seen in pseudohypoPTH?

Answer 9

low calcium
high phosphate
high PTH

Question 10

What is the treatment of pseudohypoPTH?

Answer 10

as for primary:
calcium supplements
calcitriol (active form of vit D)