Parathyroid Adenoma Flashcards
What is it?
A benign tumour of the parathyroid glands
What does it do?
Secretes excess PTH causing Primary Hyperparathyroidism (they cause 85% of hyperparathyroidism)
What does PTH do?
raises osteoclast activity in bones and stimulates release of Ca2+ and PO4^3- from bones
Why doe the adenomas form?
Their aetiology is largely unknown
Are they common?
Primary hyperparathyroidism is the 3rd most common endocrine disorder and 85% caused by Parathyroid Adenoma
Who do they affect?
These adenomas are most common in post-menopausal women
Symptoms (12)
*Often asymptomatic and detected by raised calcium on routine tests, Weak, tired, depressed, thirsty, dehydrated but polyuric, renal stones, abdominal pain, pancreatitis, stomach ulcers, bone pain, fractures
Signs (2)
Raised BP, may have a hypercalcaemic tremor/spasticity
What is the saying for hyperparathyroidism?
Bones, stones, abdo groans and psychic moans
Differentials (6)
Familial benign hypocalciuric Hypercalcaemia, Lithium induced, Malignancy, Thyrotoxicosis, Pagets disease of bone, Addisons
What bloods would you do? (8)
FBC, U&E, TFT, PTH, Calcium, LFT, Alk Phos, Vit D
Other investigations (3)
24 hour urinary calcium (raised), DEXA scan, Renal tract imaging (look for secondary Hyperparathyroidism)
Treatment (5)
Surgery to remove the adenoma, vitamin D replenishment, Bisphosphonates, Cinnacalcet (reduces calcium but raises phosphate), fluids
Complications (3)
Post surgery hypocalcaemia due to hungry bone syndrome, recurrent laryngeal nerve injury, haematoma formation
