Hyperparathyroid Disease Quiz
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Questions and Answers

What is the primary characteristic of Hyperparathyroid disease?

  • Excessive secretion of parathyroid hormone from one parathyroid gland (correct)
  • Excessive secretion of parathyroid hormone from multiple parathyroid glands
  • Normal secretion of parathyroid hormone from all parathyroid glands
  • Deficient secretion of parathyroid hormone from all parathyroid glands

    • What is the most common cause of Primary Hyperparathyroid disease?

  • Vasopressin receptor damage secondary to hyperkalemia
  • Chronic disease state leading to parathyroid cell hyperplasia
  • Secretion of PTH from a tumor in one of the parathyroid glands (correct)
  • Demineralization of bone

    • What is a complication of elevated PTH levels?

  • Demineralization of muscle
  • Pathologic fractures (correct)
  • Decreased excretion of calcium and phosphate by the kidneys
  • Hypocalcemia

    • What is the effect of excessive PTH concentrations on bone?

    <p>Demineralization and increased fragility</p> Signup and view all the answers

    Which age group is Primary Hyperparathyroid disease more frequent in?

    <p>Persons older than 40 years of age</p> Signup and view all the answers

    What is the incidence of new cases of Hyperparathyroid disease annually?

    <p>0.03%</p> Signup and view all the answers

    Which of the following is NOT a mechanism by which PTH increases serum calcium concentrations?

    <p>Inhibition of vitamin D synthesis</p> Signup and view all the answers

    What is a potential underlying cause of Secondary Hyperparathyroid disease?

    <p>Chronic renal failure</p> Signup and view all the answers

    What is the effect of PTH on the kidney?

    <p>Increased calcium reabsorption</p> Signup and view all the answers

    What is a laboratory finding that may indicate Secondary Hyperparathyroid disease secondary to Lung Cancer?

    <p>Decreased PTH level and Increased Calcium level</p> Signup and view all the answers

    What is the consequence of excessive circulating PTH and calcium on urine pH?

    <p>Abnormally alkaline urine</p> Signup and view all the answers

    What is the role of vitamin D in PTH-mediated calcium absorption?

    <p>Stimulates calcium absorption</p> Signup and view all the answers

    What is the prevalence of Hyperparathyroid disease in children?

    <p>Rare</p> Signup and view all the answers

    What is the consequence of excessive PTH and calcium on renal stone formation?

    <p>Increased risk of calcium-containing renal stones</p> Signup and view all the answers

    What is the effect of PTH on osteoclast activity?

    <p>Stimulates osteoclast activity</p> Signup and view all the answers

    What is the net effect of PTH on serum calcium concentrations?

    <p>Increase in serum calcium concentrations</p> Signup and view all the answers

    What is the effect of hypercalcemia on the gastrointestinal tract in HPTH disease?

    <p>Decreases peristalsis leading to constipation</p> Signup and view all the answers

    Which of the following is a characteristic of primary HPTH disease?

    <p>Serum phosphate is typically low</p> Signup and view all the answers

    What is the relationship between the size of a parathyroid adenoma and the serum PTH concentration?

    <p>The size of the parathyroid adenoma is directly related to the serum PTH concentration</p> Signup and view all the answers

    Which of the following is NOT a characteristic of secondary HPTH disease?

    <p>Urinary calcium and phosphate levels are often elevated</p> Signup and view all the answers

    What is the purpose of imaging tests in HPTH disease?

    <p>To localize a parathyroid tumor</p> Signup and view all the answers

    What is the clinical hallmark of primary HPTH disease?

    <p>Hypercalcemia</p> Signup and view all the answers

    Which of the following tests is used to diagnose HPTH disease?

    <p>Immunoradiometric assay</p> Signup and view all the answers

    What is scintigraphy used for in diagnosing diseases?

    <p>To record the distribution of radioactivity in a particular tissue</p> Signup and view all the answers

    What is the recommended treatment for asymptomatic HPTH disease with high serum calcium levels?

    <p>Surgical removal of the parathyroid glands</p> Signup and view all the answers

    What is the goal of subtotal parathyroidectomy in treating parathyroid hyperplasia?

    <p>To remove three and one-half parathyroid glands</p> Signup and view all the answers

    Why are patients with HPTH disease advised to avoid thiazide diuretics?

    <p>Because they increase serum calcium levels</p> Signup and view all the answers

    What is the treatment for parathyroid carcinomas?

    <p>Surgical removal of the tumor followed by radiation therapy</p> Signup and view all the answers

    Why is calcium carbonate given orally after surgery?

    <p>To reduce the probability of developing hypocalcemia</p> Signup and view all the answers

    What is the cause of paresthesias and tetany after surgery?

    <p>Hypocalcemia</p> Signup and view all the answers

    What is the treatment for symptomatic hypocalcemia?

    <p>Larger doses of calcium and occasionally calcitriol</p> Signup and view all the answers

    What is the main purpose of administering propranolol in patients with hyperparathyroid disease?

    <p>To prevent adverse cardiac effects associated with high circulating levels of thyroid hormones</p> Signup and view all the answers

    What is the treatment of choice for severe hypercalcemia associated with hyperparathyroid disease?

    <p>Intravenous saline hydration</p> Signup and view all the answers

    What is the mechanism of action of bisphosphonates in treating hypercalcemia?

    <p>Inhibiting bone resorption</p> Signup and view all the answers

    Why is vitamin D replacement beneficial in patients with hyperparathyroid disease?

    <p>It alleviates symptoms of vitamin D deficiency</p> Signup and view all the answers

    What is the effect of cinacalcet hydrochloride on parathyroid hormone secretion?

    <p>It decreases PTH secretion</p> Signup and view all the answers

    What is a potential complication of hypercalcemia associated with hyperparathyroid disease?

    <p>Pancreatitis</p> Signup and view all the answers

    What is the goal of treatment for bone disease associated with secondary hyperparathyroidism in renal failure patients?

    <p>To prevent hyperphosphatemia</p> Signup and view all the answers

    What is the route of administration of bisphosphonates in treating hypercalcemia associated with hyperparathyroid disease?

    <p>Intravenous</p> Signup and view all the answers

    Study Notes

    Hyperparathyroid Disease (HPTH)

    • Characterized by excessive secretion of parathyroid hormone (PTH) from one or more parathyroid glands, leading to hypercalcemia, hypophosphatemia, and increased excretion of calcium and phosphate by the kidneys.

    Etiologies

    • Primary HPTH: caused by a tumor in one of the parathyroid glands, leading to excessive PTH secretion.
    • Secondary HPTH: caused by chronic disease states, such as chronic renal failure, leading to decreased serum calcium levels and parathyroid cell hyperplasia.

    Prevalence

    • Primary HPTH: incidence of 0.1-0.2%, more frequent in persons older than 40 years, and 2-3 times more common in women than men.
    • Secondary HPTH: rare in children, with an overall incidence of new cases approximately 0.03% annually.

    Pathophysiology

    • PTH stimulates osteoclasts, leading to excessive bone resorption and demineralization.
    • PTH increases calcium reabsorption in the kidneys.
    • PTH stimulates vitamin D synthesis, leading to increased gastrointestinal calcium absorption.

    Clinical Manifestations

    • Hypercalcemia: can lead to abdominal pain, peptic ulcer disease, constipation, and neuro psychiatric illnesses.
    • Muscular weakness and muscle pain (myalgia) are linked to degenerative changes in muscles and nerves.
    • Hypercalcemia can cause susceptibility to developing calcium-containing kidney stones.

    Diagnosis

    • Characterized by a significant elevation in serum PTH concentration.
    • Immunoradiometric assay (IRMA) is a specific and sensitive test for PTH.
    • Hypercalcemia is often present, with urinary calcium and phosphate levels elevated, and serum phosphate typically low.
    • Bone x-ray changes may be present, but are not required for a definitive diagnosis.

    Treatment

    • Surgical removal of parathyroid glands (parathyroidectomy) is recommended for symptomatic HPTH disease.
    • Non-pharmacologic and pharmacologic treatments may also be applicable.
    • Patients with mild, asymptomatic disease should keep active, avoid immobilization, and drink plenty of fluids.

    Complications and Prognosis

    • Serious complications include renal failure, pathologic fractures, and hypercalcemia-induced pancreatitis.
    • Prognosis is generally good with treatment, but severe complications can increase mortality rates.

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    Related Documents

    Hyperparathyroid Disease PDF

    Description

    Test your knowledge of hyperparathyroid disease, an endocrine disorder characterized by excessive secretion of parathyroid hormone, leading to hypercalcemia and other symptoms.

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