Hypoparathyroidism

Question 1

Define hypoparathyroidism

Answer 1

Hypoparathyroidism = too little PTH released

Question 2

Describe the epidemiology of hypoparathyroidism

Answer 2

• US: 37 per 100,000

- Denmark: 22 per 100,000

Question 3

What are the causes of hypoparathyroidism

Answer 3

1. ) Thyroidectomy/cancer treatment for neck: thyroid gland removal can damage the parathyroid glands
2. ) Hypomagnesemia: inhibits PTH
3. ) Autoimmune destruction of parathyroid glands: Di-George syndrome
4. ) Congenital
5. ) Vitamin D deficiency

Question 4

Describe the pathology of hypoparathyroidism

Answer 4

• In causes

Question 5

What are the main signs and symptoms of hypoparathyroidism

Answer 5

• Remember PTH
• P: peripheral paraesthesia (symptom) + positive trousseau and chvostek signs (sign)
• T: tetany (sign) : spasms of hands and feet/larynx/premature labour (uterine contractions) (spasms themselves are a symptom)
• H: Hypomagnesemia + hyperphosphatemia
• Also: anxiety/muscle tone increase/seizure (symptom)
• Convulsion/arrhythmia (sign)

Question 6

Describe the investigations and the diagnosis for hypoparathyroidism

Answer 6

• positive trousseau and chvostek sign
• PTH test: shows low PTH
• Bloods: hypomagnesemia/hypocalcaemia and hyperphosphatemia

Question 7

What is the treatment and management for hypoparathyroidism

Answer 7

• IV calcium e.g. calcium gluconate (risk: can cause digoxin toxicity so be aware)
• Phosphate binders: e.g. aluminium carbonate that bind phosphate

Question 8

What is the treatment and management for hypoparathyroidism

Answer 8

• IV calcium e.g. calcium gluconate (risk: can cause digoxin toxicity so be aware)
• Phosphate binders: e.g. aluminium carbonate that bind phosphate

from online notes:

• calcium supplement
• calcitriol (active vit D)
• synthetic PTH