Parathyroid Disorders

Question 1

what is hyperparathyroidism?

Answer 1

when the parathyroids secrete too much PTH

Question 2

what does high PTH cause?

Answer 2

high serum Ca2+

Question 3

primary hyperparathyroidism causes

Answer 3

adenomas
hyperplasia
carcinomas

Question 4

secondary hyperparathyroidism causes

Answer 4

chronic hypocalcaemia with compensatory overactivity of parathyroids

Question 5

tertiary hyperthyroidism causes

Answer 5

associated with autonomous activity after many years of secondary

Question 6

what can cause chronic hypocalcaemia?

Answer 6

chronic renal disease causes vitamin D deficiency (helps your body absorb calcium)

Question 7

presentation of hyperparathyroidism buzzword

Answer 7

bones
stones
abdominal groans
psychic moans

Question 8

presentation of hyperparathyroidism

Answer 8

bone pain, fractures, OP, osteitis fibrosa cystica
renal stones
GI constipation
depression, lethargy, weakness and fatigue

Question 9

diagnosis of hyperparathyroidism

Answer 9

PTH and calcium levels

sestamibi scan

Question 10

bloods in primary hyperparathyroidism

Answer 10

PTH raised

calcium raised

Question 11

bloods in secondary hyperparathyroidism

Answer 11

PTH raised

calcium low

Question 12

bloods in tertiary hyperparathyroidism

Answer 12

PTH raised

calcium raised

Question 13

management of hyperparathyroidism

Answer 13

surgery
cinacalcet
fluids, low calcium and vitamin D diet

Question 14

when is surgery indicated in hyperparathyroidism

Answer 14

<50
reduced eGFR
end organ damage (osteitis fibrosa cystica, Brown’s tumours)

Question 15

causes of hypoparathyroidism

Answer 15

DiGeorge syndrome
destruction (surgery, malignancy, radiation)
AI

Question 16

presentation of hypoparathyroidism

Answer 16

altered mental state e.g. emotional liable, anxiety, confusion
prolonged QT
cataracts
dental abnormalities
tetany

Question 17

diagnosis of hypoparathyroidism

Answer 17

bloods= low Ca2+ and PTH
Chvostek’s sign (facial nerve twitch)
Trousseau’s sign (BP cuff)

Question 18

management of hypoparathyroidism

Answer 18

calcium and vitamin D supplements

Question 19

what is pseudohypoparathyroidism

Answer 19

abnormality in the PTH receptor

Question 20

presentation of pseudohypoparathyroidism

Answer 20

McCune Albright
obesity
brachydactyly 4th metacarpal