MSRA: Parathyroids

Question 1

What are the features of hypercalcaemia?

Answer 1

Renal stones
Abdominal pain
Polydipsia
Polyuria
Fatigue
Peptic ulceration

Question 2

What are the features of hypocalcaemia?

Answer 2

Seizures
Muscle spasms
Perioral paraesthesia

Question 3

What are the actions of PTH?

Answer 3

1. Increased activation of vitamin D (takes place in kidneys)
2. Bone breakdown
3. Increased absorption by the kidneys (in exchange for phosphate excretion)

Question 4

What is meant by pseudohypoparathyroidism?

Answer 4

Target cells insensitive to PTH

Question 5

What are the blood results in secondary hypoparathyroidism from CKD?

Answer 5

Low calcium
Raised PTH (in response to low calcium)
Raised ALP (PTH stimulates bone breakdown)
Raised phosphate (kidneys unable to remove and excrete in to urine)

Question 6

What is the first-line management in hypercalcaemia?

Answer 6

IV Fluids

Question 7

What are the ECG changes in hypocalcaemia?

Answer 7

Prolonged QT interval

Question 8

Name 5 causes of hypercalcaemia

Answer 8

Primary hyperparathyroidism
Malignancy
Sarcoidosis
Thiazide diuretics
Thyrotoxicosis
Dehydration

Question 9

What is the management of severe hypocalcaemia?

Answer 9

IV calcium replacement (calcium gluconate)