Primary HyperPTH

Question 1

Primary Hyperparathyroidism is often ?. If there are symptoms, they are related to ?;

Bones.
Bone pain, ? fractures, ? weakness.
Stones.
Renal stones, ?, ?/?.
? groans.
? pain, vomiting, ?, ?, GI ?.
? moans:
?, ?, tiredness, hypotonicity.

Answer 1

aSx
hypercalcaemia
pathological
muscle
polyuria
AKI/CKD
abdominal
abdo
constipation
pancreatitis
ulcers
psychic
depression
confusion

Question 2

ECG will show ? ? interval, and this can lead to ? ?

Answer 2

reduced QT

cardiac arrest

Question 3

Investigations;
PTH: ?.
Ca2: ?.
?- ·: reduced.
???: raised.

Answer 3

raised
raised
Phosphate
ALP

Question 4

Ix
?h ? calcium: raised.
o Important to rule out ? ? hypercalcaemia.
• Can present similarly.
• Can use a spot ?:? excretion alternatively.

Answer 4

24 h urinary
familial hypocalciuric
calcium:creatinine

Question 5

Ix
? scan: vital to assess extent of ?.
—o ? XRs show classic ? bone resorption.
? localization;
o ? scanning: show areas of increased uptake
o ?: requires highly skilled operator.

Answer 5

dexa
osteoporosis
hand
subperiosteal
technetium
uss

Question 6

Primary can be separated from tertiary hyperparathyroidism fairly easily based on
? presentation, and ? levels are also helpful.
Usually ?/? in primary hyperparathyroidism.

Answer 6

clinical
phosphate
low
normal

Question 7

Primary Hyperparathyroidism can be associated with the ? syndromes, inherited in an autosomal ? fashion.

Answer 7

MEN

dominant

Question 8

MEN 1 all the P’s

? hyperplasia/ adenoma.
? endocrine tumours: gastrinoma / ?.
? adenoma.

Answer 8

parathyroid
pancreatic
insulinoma
pituitary

Question 9

MEN 2a; TAP
?: Medullary ?.
?: PCC.
?: hyperplasia

Answer 9

Thyroid
Ca
Adrenal
Parathyroid

Question 10

MEN 2b;
MEN ? + ? neuromas + ? appearance.
No hyper?

Answer 10

2a
mucosal
marfan
PTH