Parathyroid

Question 1

What is the classic presentation of primary hyperparathyroid?

Answer 1

Elderly female with unquenchable thirst and normal or raised PTH

Question 2

What is the most common cause of primary hyperparathyroid?

Answer 2

Solitary adenoma

Question 3

What are the features of hyperparathyroid?

Answer 3

"Bones, stones, abdominal groans and psychic moans"
Bone pain/fracture 
Renal stones 
Peptic ulcer, constipation 
Depression

Question 4

What investigations are done for primary hyperparathyroid?

Answer 4

Raised Ca, low phosphate
PTH raised or inappropriately normal (should be raised given Ca level)
Pepperpot skull on XR

Question 5

What is the management of primary hyperparathyroid?

Answer 5

Total parathyroidectomy

Question 6

What are the PTH, Ca and phosphate levels in hypoparathyroid?

Answer 6

Low PTH

Low Ca, high phosphate

Question 7

What is the presentation of hypoparathyroid?

Answer 7

Symptoms of hypocalcaemia- Muscle twitching, cramping, spasm

Question 8

What is pseudohypoparathyroid?

Answer 8

Genetic
Target cells insensitive to PTH
High PTH
Low Ca, high phosphate

Question 9

What is the presentation of pseudohypoparathyroid?

Answer 9

Low IQ
Short stature
Shortened 4th and 5th metacarpals

Question 10

What is pseudopseudohypoparathyroid?

Answer 10

Similar phenotype to pseudohypoparathyroid but normal biochemistry