Parathyriod

Question 1

What are the causes of primary parathyriodism?

Answer 1

Solitary adenoma (80%)
Hyperplasia (15%)
Multiple adenoma (4%)
Carcinoma (1%)

Question 2

How should the parathyriod react to high levels of calcium? What would it indicates if this didn’t happen?

Answer 2

High calcium - feedback to PT gland - decrease PTH levels

If they remain normal or high, suggests a hyperparathyriod- usually caused by adenoma

Question 3

What are the features of hypercalcaemia?

Answer 3

Polyuria, Polydipsia,
Peptic ulceration, constipation, pancreatitis 
Bone pain, fractures,
Renal stones
Depression
Hypertension 

‘Bones, stones, abdominal groans and psychic moans’

Question 4

Blood test results in primary hyperparathyriodism?

Answer 4

Raised calcium, low phosphate

PTH - normal or raised,

Question 5

What is tertiary hyperparathyriodism?

Answer 5

Renal disorder causing hyperplasia of parathyriod gland - when renal problem is sorted then glands are still hypertrophied and ⬆️ PTH released,

Bloods: 
⬆️PHT
⬆️ or normal ca2+
⬇️ or normal phosphate 
⬆️ALP
⬇️ or normal vitamin D