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P2 ENDO > Parathyroid Problems > Flashcards

Parathyroid Problems Flashcards

1
Q

Where is parathyroid hormone (PTH) secreted from?

A

Parathyroid glands

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2
Q

What stimulates release of PTH?

A

Decrease in ionised Ca2+ levels

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3
Q

What does PTH do? (3)

A
  • Increase bone resorption (via osteoclasts)
  • Kidney: increase Ca2+ reabsorption and phosphate excretion; activates 1,25-dihydroxyVD
  • Intestine: increase Ca2+ absorption
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4
Q

What is hyperparathyroidism?

A

Overproduction of PTH

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5
Q

What causes primary hyperparathyroidism? (2)

A
  • Benign parathyroid adenoma

- Parathyroid hyperplasia

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6
Q

What is the cause of secondary hyperparathyroidism?

A

Hypocalcemia (due to CKD, VD deficiency etc)

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7
Q

What are the clinical presentations of a pt w/ primary hyperparathyroidism (hypercalcemia)? (5)

A
  • Painful BONES: osteoporosis, fracture
  • Kidney STONES
  • Psychic MOANS: confusion, depression, lethargy/ fatigue
  • Abdominal GROANS: constipation
  • THRONES: polyuria, polydipsia
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8
Q

What are the investigations for hyperparathyroidism? (3)

A
  • Bloods
  • Increased 24hr urinary calcium excretion
  • DEXA bone scan
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9
Q

What blood results would you expect to see in a pt w/ primary hyperparathyroidism? (3)

A

Raised PTH
Raised Ca2+
Low phosph

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10
Q

What blood results would you expect to see in a pt w/ secondary hyperparathyroidism? (3)

A

Raised PTH
Low Ca2+
Raised phosph

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11
Q

What blood results would you expect to see in a pt w/ tertiary hyperparathyroidism?

A

Raised PTH, Ca2+, phosph

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12
Q

How would you treat hyperparathyroidism? (3)

A
  • Fluids (to prevent stones)
  • Surgically treat underlying cause
  • Bisphosphonates (osteoporosis)
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13
Q

What is hypoparathyroidism?

A

Underproduction of PTH

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14
Q

What is the physiological effect of hypoparathyroidism on the body?

A

Hypocalcaemia + hyperphosphatemia = neurons more excitable

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15
Q

What are the causes of hypoparathyroidism? (3)

A
  • Surgical removal
  • Autoimmune destruction of PT glands
  • Congenital: Digeorge
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16
Q

What are the symptoms of hypoparathyroidism (hypocalcemia)? (6)

A 
SPASM C
Spasms
Peripheral paresthesia
Anxious
Seizures
Muscle tone decreases
Cataracts
17
Q

What are the signs of hypoparathyroidism (hypocalcemia)? (2)

A

Chvostek’s sign (tapping facial nerve –> facial twitch)

Trousseau’s sign (bp cuff inflation causes flexion of wrist + fingers)

18
Q

How would you investigate hypoparathyroidism? (2)

A
  • Blood tests: low PTH

- ECG: long QT, long ST; arrhythmias

19
Q

How would you treat hypoparathyroidism? (3)

A
  • Ca2+ supplement
  • Calcitriol (activated vit D)
  • Synthetic PTH

P2 ENDO (10 decks)

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