Hyperparathyroidism Flashcards
which cells is PTH released from
Cheif cells of the parathyroid gland
released when there is low Ca
action of PTH
increased Ca absorption in the gut
increased Ca reabsorption in the kidney
increased osteoblast activity
what is primary hyperparathyroidism
uncontrolled PTH release from a tumour
increased PTH and Calcium
what is secondary hyperparathyroidism
vitamin D deficiency or CKD
leads to low/normal calcium
glands respond by increasing PTH production
what is tertiary hyperparathyroidism
progression of secondary, leads to hyperplasia of the glands
increased PTH and calcium
how can hyperparathyroidism present
bone (pain)
abdominal groans (constipation, N+V)
stones
psychiatric groans (fatigue, depression, psychosis)
what signs can occur in hyperparathyroidism as a result of hypercalcaemia
slow or absent reflexes
slow muscle contraction - weakness/ constipation
dehydration - body trys to offload excess Ca and water follows
what are some other causes of hypercalcaemia
paraneoplastic syndromes
malignancy (can kill osteoblasts)
excessive vitamin D
thiazides
acidosis
management of hypercalcaemia
give fluids (increases urinary excretion)
loop diuretics (inhibit reabsorption of Ca)
glucocorticoids (decrease gut absorption)
bisphosphonates
