Parathyroid Conditions, Signs, Causes Amd Differentials

Question 1

What is primary hyperparathyroidism?

Answer 1

(Not the first step from primary to tertiary)
Increase in PTH and calcium and decrease in phosphate due to overactivity of parathyroid glands.

Most often due to: adenoma

Question 2

What are the symptoms of hyperparathyroidism?

Answer 2

Hypercalcemia: stones, bones, psychic moans, GI groans, dehydrated and Polyuric

Bone resorption: bone pain, fractures

Question 3

How is primary hyperparathyroidism different to secondary hyperparathyroidism?

Answer 3

Secondary hyperparathyroidism causes low calcium and primary causes high calcium

Question 4

What are the causes of secondary hyperparathyrodism?

Answer 4

Both relate to vitamin D:

1. Chronic kidney disease
2. Reduced vitamin D intake

Effect: Reduced vitamin D action means reduced calcium GI uptake and reduced calcium release from bone - resulting in hypocalcaemia, and the parathyroid gland produces more PTH in reaction to this.

Question 5

What is tertiary hyperparathyroidism?

Answer 5

A progression from secondary hyperparathyroidism - after a prolonged state of low calcium in secondary hyperparathyroidism, the parathyroid gland becomes autonomous and starts producing massive amounts of PTH.

This causes: very high calcium levels