Thyroid/parathyroid pathology 2

Question 1

What is the common pathology affecting the parathyroid glands ?

Answer 1

• Hyperparathyroidism
• Hypoparathyroidism
• Hyperplasia/adenoma/carcinoma

Question 2

What are the symptoms of hyperparathyroidism ?

Answer 2

• General tirdeness
• Muscle weakness

Question 3

What are some of the complications which can develop due to hyperparathyroidism ?

Answer 3

Bone disease:

• Pain, fracture, osteoporosis or osteitis fibrosa cystica

Nephrolithiasis:

• Renal stones and complications

GI complications:

• Constipation, nausea, peptic ulcer disease, pancreatitis, gall stones

CNS:

• Depression, lethargy, seizures

Neuro-muscular:

• Weakness and fatigue

CVS:

• Calcification of aortic and mitral valves

Question 4

What are the main cause of primary hyperparathyroidism ?

Answer 4

Parathyroid adenoma

Carcinoma in only 2-3% of cases

Question 5

How does secondary hyperparathyroidism occur ?

Answer 5

1. Persisten low serum calcium
2. Results in increased stimulation of parathyroid hormone release

Question 6

What is secondary hyperparathyroidism seen in ?

Answer 6

• Renal failure most commonly ==> treat the renal failure
• May also be due to malabsorption syndromes with Vit D deficiency ==> medical treatment by giving the synthetic version of vitamin D called 1 alpha calcidol

Question 7

What is tertiary hyperparathyroidism ?

Answer 7

• When a patient with secondary hyperparathyroidism becomes hypercalcaemic.
• Thought to be due to some cells becoming autonomous in the parathyroid i.e. insensitive to the controlling effect of Ca2+ and an inappropriate high level of PTH secreted as a result

Question 8

How does hypoparathyroidism occur ?

Answer 8

• Due to deficiency of PTH
• This causes hypocalcaemia and hyperphosphataemia

Very rare

Question 9

What are some of the signs of hypoparathyroidism ?

Answer 9

• Increased muscular tone
• Muscle spasms

Question 10

What are some of the complications of hypoparathyroidism ?

Answer 10

• Cataracts
• Psychological changes
• Seizures
• Prolong QT interval in ECG

Question 11

What are some of the causes of hypoparathyroidism ?

Answer 11

• Usually after removal of the glands
• Rarely congenital absence – Di George syndrome