Parathyroid

Question 1

PTH is secreted from the parathyroid gland. When is it secreted? What action does it have?

Answer 1

-it’s secreted in response to low serum calcium or high serum phosphate

• increases serum calcium by:
  
  • increase Ca2+ reabsroption in the kidney
  • increase Ca2+ absorption in the GI tract
  • increase Ca2+ release from the bones from osteoclast activity

Question 2

Explain primary hyperparathyroidism.

Answer 2

• increase in PTH due to a primary tumour of the parathyroid gland
• increases blood calcium, decreases phosphate
• bones, stones, groans, psychiatric overtones.

Question 3

Explain secondary hyperparathyroidism.

Answer 3

• increase in PTH due to a low calcium level either because of low Vit D or CKD
• calcium is normal to low, phosphate normal or high (CKD causes retention
• may be asymptomatic, may have osetolytic disease sooner or later

Question 4

Explain tertiary hyperparathyroidism.

Answer 4

• increase in PTH due to hyperplasia of the parathyroid gland which was caused by secondary hyperparathyroidism
• happens when the underlying cause of 2nd hyperPTH is treater but the hyperplasic gland still produces BARE PTH
• more Sx
• increases Ca2+, decreases PO4-

Question 5

What is the most common causes hypoparathyroidism?

Answer 5

• First - iatrogenic damage to the parathyroid gland - thyroidectomy, parathyroidectomy or radial neck dissection
• Second - autoimmmune
• non-autoimmune destruction - HIV, toxic shock, gram -ve sepsis, wilson’s
• congential

Question 6

What is the name of congenital parathyroid aplasia?

Answer 6

-Digeorge’s

Question 7

What are the clinical features of hypoparathyroidism?

Answer 7

• clinical features of hypocalcaemia
• tetany
• trausseau’s + chovtek’s
• puffy skin
• cataracts
• depression
• Prolonged QT

Question 8

What is the treatment for hypoparathyroidism?

Answer 8

aldacalcidol