Primary Hyperparathyroidism Flashcards
What causes Primary Hyperparathyroidism?
Excess PTH secretion by either:
85%: solitary adenoma
10%: hyperplasia
4%: multiple adenoma
1%: carcinoma
What percentage of patients with Primary Hyperparathyroidism are asymptomatic at diagnosis?
80%
mostly diagnosed on routine bloods
What is the mnemonic to remember the features of Primary Hyperparathyroidism
Bones
stones
abdominal groans
psychiatric moans
Describe the clinical features of hyperparathyroidism
bone pain/fracture
renal stones
peptic ulceration
pancreatitis
nausea, constipation
depression
Anorexia,
polyuria/polydipsia
hypertension
Primary hyperparathyroidism is associated with what other conditions?
hypertension
Multiple endocrine neoplasia: MEN I and IIa
What investigations can be used to make a diagnosis of hyperparathyroidism?
- high calcium, low phosphate
- PTH raised
- technetium-MIBI subtraction scan
What X-Ray findings can be seen in Primary Hyperparathyroidism?
pepperpot skull
osteitis fibrosa cystica
Management of Primary Hyperparathyroidism
- Total parathyroidectomy
Conservative mx if:
- Ca <0.25 above upper limit of normal
- patient >50y
- no end organ damage
patients not suitable for surgery
= cinacalcet (calcimimetic)
