Parathyroid Disease Flashcards
What is the main cause of hyperparathyroidism?
Adenomas
Name 2 other causes of primary hyperparathyroidism.
MEN 1/2
Carcinoma
What is the profile of primary hyperparathyroidism in terms of Ca, phosphate, PTH and ALP?
High Ca
Normal phosphate
High PTH
Normal ALP
What causes secondary hyperparathyroidism + what is the profile in terms of Ca and PTH?
Low calcium/vit D
Low Ca
High PTH
What is the cause of tertiary hyperparathyroidism + what is the profile in terms of Ca and PTH?
Autonomy after prolonged overactivity
High Ca
High PTH
Hyperparathyroidism/ hypercalcemia symptoms?
Bones
Stones
Abdominal groans
Psychic moans
What scan is used to locate parathyroid tumours causing hyperparathyroidism?
Sestamibi scan
Treatment of primary/ tertiary hyperparathyroidism?
Parathyroidectomy
4 parts of treatment for secondary hyperparathyroidism due to CKD?
Parathyroidectomy
Bisphosphonates
Calcium/Vit D supplements
Thiazide diuretics
Name 4 causes of hypercalcemia.
Hyperparathyroidism
High bone turnover
Malignancy
Thiazide diuretics
Treatment for acute + chronic hypercalcemia?
Acute = IV calcium gluconate Chronic = calcium and vit D supplements
Hypercalcemia with normal/low PTH and high ALP would suggest?
Bone disease
What is the profile of bone malignancy in terms of Ca, phosphate, PTH and ALP?
High Ca
Normal phosphate
Normal PTH
High ALP
What is osteomalacia profile in terms of Ca, phosphate, PTH and ALP?
Low/normal Ca
Low phosphate
Low/normal PTH
High ALP
What is hypoparathyroidism usually seen as + profile in terms of Ca, phosphate, PTH and ALP?
Post-surgery complication Low Ca Normal/high phosphate Low PTH Normal ALP
Name 4 causes of hypoparathyroidism.
Di George syndrome
Trauma
Autoimmunity
Hypomagnesia
Name 4 symptoms of hypoparathyroidism.
Neuromuscular disease
Mental illness
Long QT
Dental disease
What sign taps the facial nerve to test for hypocalcemia + positive result?
Chvotek’s
Facial twitching
What sign inflates BP cuff above SBP for 3 minutes to test for hypocalcemia + positive result?
Trousseau’s
Carpopedal spasm
What is the treatment for hypoparathyroidism?
Calcium/Vit D supplements
Familial hypoparathyroidism occurs with other endocrine disorders such as?
Primary adrenal insufficiency
What is pseudohypoparathyroidism?
Resistance to PTH causing hypocalcemia
What genetic mutations is pseudohypoparathyroidism caused by and how does this affect PTH?
GNAS1
Decreases response to PTH so PTH elevated
What receptor in the parathyroid gland detects Ca levels?
CaSR
Name 4 signs of pseudohypoparathyroidism?
Bone disease
Obesity
Learning difficulty
Brachydactyly
What is the mutation + inheritance of FHH?
CaSR mutation
AD
What genetic condition causes high blood calcium and low urine calcium without parathyroid disease?
Familial hypocalciuric hypercalcemia (FHH)
Which electrolyte needs to be low to allow calcium release from cells?
Magnesium
3 drugs for chronic vitamin D deficiency?
Vitamin D3
Calcitrol
Alfacalcidol
Name 4 causes of hypo magnesia.
Alcohol
Thiazide diuretics
PPIs
GI disease
Name 3 causes of hypocalcemia.
Hypoparathyroidism
Vitamin D deficiency
CKD
What is the extreme manifestation of vitamin D deficiency in children + adults?
Children = rickets Adults = osteomalacia
