parathyroid

Question 1

primary hormone profile

Answer 1

PTH (Elevated)
Ca2+ (Elevated)
Phosphate (Low)
Urine calcium : creatinine clearance ratio > 0.01

Question 2

cause of primary

Answer 2

solitary adenoma

Question 3

secondary hormone profile

Answer 3

PTH (Elevated)
Ca2+ (Low or normal)
Phosphate (Elevated)
Vitamin D levels (Low)

Eventually may develop bone disease, osteitis fibrosa cystica and soft tissue calcifications

Question 4

secondary hyperparathyroid - why does parathyroid gland hyperplasia occur

Answer 4

Parathyroid gland hyperplasia occurs as a result of low calcium, almost always in a setting of chronic renal failure

Question 5

tertiary hormone profile

Answer 5

Ca2+ (Normal or high)
PTH (Elevated)
Phosphate levels (Decreased or Normal)
Vitamin D (Normal or decreased)
Alkaline phosphatase (Elevated)

Question 6

features of tertiary

Answer 6

Metastatic calcification
Bone pain and / or fracture
Nephrolithiasis
Pancreatitis

Question 7

why does tertiary occur

Answer 7

Occurs as a result of ongoing hyperplasia of the parathyroid glands after correction of underlying renal disorder, hyperplasia of all 4 glands is usually the cause

Question 8

which is commonly managed with meds

Answer 8

secondary

Question 9

which is commonly managed with surgery based off indications

Answer 9

primary

Question 10

A 55-year-old woman presents to the GP with widespread bone pain and fatigue. Occasionally, she has had muscle twitches and numbness around her mouth. Her past medical history includes stage 4 chronic kidney disease.

Blood tests show the following:

Answer 10

secondary as usually symptomatic