Hypoparathyroidism Flashcards

1
Q

D?

A

A relative or absolute deficiency of parathyroid hormone as there is either a lack of synthesis of a lack of secretion.

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2
Q

RF?

A
  • Thyroid surgery
  • Parathyroid surgery
  • Hypomagnesaemia
  • Mod and chronic maternal hypercalcaemia
  • AD conditions
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3
Q

ddx?

A

• Hypovitaminosis D-high PTH
• Hypomagnesaemia-
• Hypoalbuminemia
• Pseudohypoparathyroidism-
• end-organ (i.e., bones andkidneys) resistance toparathyroid hormone(PTH) despite sufficientPTHsynthesis due to adefectiveGsproteinalpha subunit
• Pseudopseudohypoparathyroidism-extremely rare condition that mimicsPHP type 1abut withoutend-organresistance toPTH
Renal failure/CKD-high creatinine

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4
Q

Aetiology?

A
  • Post-op injury
  • Autoimmune
  • Congenital
  • Infiltration-(Wilson’s disease,hemochromatosis,granulomas,metastases)
  • Radiation-induced destruction
  • Gram-negative sepsis
  • Toxic shock syndrome
  • HIV infection
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5
Q

CP?

A
  • Symptoms of hypocalcaemia
  • Chvostek sign-hyperexcitable nerves and contraction of facial muscles
  • Trousseau-Occlusion of brachial artery with BP cuff causes carpal spasm
  • Extrapyramidal disorders
  • Ocular disease
  • Skeletal-increases density and osteosclerosis
  • Dental-hypoplasia
  • Cutaneous-dry puffy coarse skin
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6
Q

Pathophysiology?

A

• Damage to glands in neck surgery or radiation therapy/infection
• In infiltration, compounds like excess copper, iron , fibrous tissue and cancerous cells are deposited here which cause destruction and dysfunction of the parathyroid gland.
• If there is low calcium, PTH cannot be secreted to increase vitamin D levels and absorption, so either vitamin D takes over or there is a lack of calcium and phosphate and magnesium as they are co-transported.
• It also means that there is less free calcium in the blood.
However, if there is somehow a build up of calcium, there is no NF to reduce PTH and so reduce increases in calcium-depositions with medications or exogenous sources.

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7
Q

I-first line?

A
• Serum calcium-low
• Serum albumin-normal
• ECG-Prolonged QT
• Plasma PTH-low or normal
• Serum magnesium-low
• Serum vitD-low
• Serum phosphorus-high
• Serum creatinine-normal
• 24-hr urine tests-low
FBC-exclude anaemia
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8
Q

I-second line?

A

Excluding pathologies/causes-imaging, eye and ear exams, other electrolytes and hormones

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9
Q

M-severe?

A

• IV calcium gluconate
• Parenteral Magnesium sulphate
• Treat for resp alkalosis-
• Alkalosis can reduce the ionised fraction of serum calcium by favoring calcium binding to albumin
Symptomatic-oral calcium or low dose calcitriol

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10
Q

M-ongoing?

A

• Oral calcium plus calcitriol-after surgery
• PTH
• Thiazide-hypercalciuria
• Oral magnesium
Treat underlying condition-autoimmune polyendocrine syndrome 1, coeliac disease or drugs.

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11
Q

P?

A

• Good prognosis if after surgery, damaged take longer ot recover
Hard to manage calcium levels in permanent

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12
Q

C?

A
• Ectopic calcifications
• Cataract
• Hypercalcaemia
• Renal insufficiency
Renal stones
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