primary hyperparathyroidism

Question 1

what is hyperparathyroidism?

Answer 1

overproduction of PTH by parathyroid chief cells

Question 2

how do most patients present?

Answer 2

majority of patients with primary hyperparathyroidism are assymptomatic

Question 3

clinical features : kidneys

Answer 3

1. nephrocalcinosis

2. polyuria and polydipsia

Question 4

clinical features : MSK

Answer 4

1. bone pain
2. peudogout
3. skull - decalcification (salt and pepper skull)

Question 5

clinical features : GI

Answer 5

1. lack of appetite
2. nausea and constipation
3. gastric / duodenal ulcers

Question 6

clinical features - neuropsych

Answer 6

1. anxiety

2. depression

Question 7

What are the lab results for each of the following;

1. calcium
2. phosphate
3. alkaline phosphotase
4. PTH

Answer 7

1. calcium is high
2. phophate is low
3. ALP is high
4. PTH is high

Question 8

Max - First line

Answer 8

1. surgical

para/total parathyroidectomy

Question 9

When is surgical management indicated?

Answer 9

1. symptomatic patient

2. assymptomatic but high calcium/nephtolithiasis etc

Question 10

Mx - non surgical treatment

Answer 10

1. calcimimetics

2. bisphosphonates - slows down degretation of bone