parathyroid

Question 1

aetiology?

Answer 1

1. post-surgery;
   thyroid disorders,
   hyperparathyroidism,
   and laryngeal or other head and neck cancers.
2. Nonsurgical aetiologies include:
   autoimmune destruction of the glands;
   radiation,
   hypomagnesaemia and magnesium depletion;

Question 2

presentation?

Answer 2

1. asymptomatic patient with dramatically low serum calcium
2. neuromuscular irritability, tetany, painful muscle cramps, stridor, and even seizures
   paraesthesias, numbenss, tingling
   poor memory, slowed thinking

Question 3

IVX?

Answer 3

Serum albumin - low albumin gives falsely low calcium!

Serum Mg

PTH - low or normal

Ca - low. PO4 -high

ECG - Long qt (low ca)

Question 4

mx?

Answer 4

Mild;
Oral calcium carbonate + calcitriol
recombinant pth
Oral Mg Sulfate

Severe;
IV calcium
IM Mg sulfate

Question 5

how does pseudohypoparathyroidism present

Answer 5

like hypoparathyroidism only with an elevated PTH

also some forms may have characteristic skeletal appearance eg short stature and bones - Albright’s hereditary osteodystrophy.

hypocalcaemia, hyperphosphataemia, and elevated PTH levels

Question 6

aetiology of pseudo hypo pth?

Answer 6

genetic mutation causing unresponsiveness to pth

Question 7

mx of pseudo hypo pth?

Answer 7

calcium + calcitriol + thiazide diuretics

may have to supplement other pituitary hormones