Primary hyperparathyroidism Flashcards
1
Q
Primary hyperparathyroidism?
A
- In exams, primary hyperparathyroidism is stereotypically seen in elderly females with an unquenchable thirst and an inappropriately normal or raised parathyroid hormone level.
- It is most commonly due to a solitary adenoma
2
Q
Causes of primary hyperparathyroidism?
A
- 80%: solitary adenoma
- 15%: hyperplasia
- 4%: multiple adenoma
- 1%: carcinoma
3
Q
Features - ‘bones, stones, abdominal groans and psychic moans?
A
- polydipsia, polyuria
- peptic ulceration/constipation/pancreatitis
- bone pain/fracture
- renal stones
- depression
- hypertension
4
Q
Associations with hyperparathyroidism?
A
- hypertension
- multiple endocrine neoplasia: MEN I and II
5
Q
Investigations?
A
- raised calcium, low phosphate
- PTH may be raised or normal
- technetium-MIBI subtraction scan
6
Q
Treatment?
A
- total parathyroidectomy
7
Q
Bilateral hand radiographs in a middle-aged woman demonstrating generalised osteopenia, erosion of the terminal phalangeal tufts (acro-osteolysis) and subperiosteal resorption of bone particularly the radial aspects of the 2nd and 3rd middle phalanges. These changes are consistent with a diagnosis of hyperparathyroidism.
A
