Hyperparathyroidism Flashcards
Parathyroid glands
Chief cells in glands produce parathyroid hormones in response to hypocalcaemia
Increase osteoclasts in bones
Increasing calcium absorption from gut
Increasing calcium absorption from kidneys
Increasing vitamin D activity
Symptoms of hypercalcaemia
Renal stones
Painful bones
Abdominal groans (constipation, nausea and vomiting)
Psychiatric moans (fatigue, depression, psychosis)
Primary hyperparathyroidism
Caused by uncontrolled parathyroid hormone produced directly by tumour of the parathyroid glands
Leads to hypercalcaemia
Treatment of primary hyperparathyroidism
Surgically remove the tumour
Secondary hyperparathyroidism
Insufficient vit D or chronic renal failure leads to low absorption of calcium from intestines, kidneys and bones
Causes hypocalcaemia
Parathyroid reacts by excreting more PTH
Over time leads to hyperplasia
Treatment of secondary hyperparathyroidism
Correct the vitamin D deficiency or performing renal transport to treat renal failure
Tertiary hyperparathyroidism
When secondary continues for long period of time leading to hyperplasia
Baseline PTH increases dramatically
When cause of secondary is treated, PTH remains inappropriately high leading to high absorption of calcium in the intestines, kidneys and bones
Causes hypercalcaemia
Treatment of tertiary hyperparathyroidism
Surgically removing part of the parathyroid tissue to return the parathyroid hormone to an appropriate level
Associations with primary hyperparathyroidism
HTN
Multiple endocrone neoplasia I and II
Xray findings
Pepperport skull characteristic of hyperparathyroidism
Treatment in patients not suitable for surgery
Calcimimetic (cinacalcet)
Mimics the action of calcium in tissues by allosteric activation of the calcium-sensing receptor
