Types of Hypoparathyroidism
The resulting loss of parathyroid function leads to low PTH, low calcium, and high phosphate, consistent with primary hypoparathyroidism.
Other answer options:
B: Pseudopseudohypoparathyroidism – Normal biochemistry; only phenotypic features of Albright’s hereditary osteodystrophy.
C: Pseudohypoparathyroidism – Target organ resistance to PTH; low calcium, high phosphate, but high PTH.
D: Secondary hypoparathyroidism – Term generally refers to low PTH due to suppression by hypercalcaemia (e.g. from vitamin D excess), not surgical loss.
Gynaecomastia
spironolactone (most common drug cause)
cimetidine
digoxin
cannabis
finasteride
GnRH agonists e.g. goserelin, buserelin
oestrogens, anabolic steroids
De Quervain’s thyroiditis:
Post-viral inflammatory phase: painful, tender goitre; initially hyperthyroid due to hormone leakage.
Transient hypothyroid phase: TSH rises once T3/T4 stores are depleted (seen here).
Recovery phase: eventual return to euthyroid state over weeks–months.
Thyroid scintigraphy shows diffusely reduced uptake throughout because inflammation impairs iodine trapping.
Hypercalcaemia
Management:
Admit patients with severe symptoms or severe hypercalcaemia (>3.4 mmol/L) for management with IVI +/- IV bisphosphonates
If minimally symptomatic or mild-mod(2.6-3.4 mmol/L), consider management in the community: address underlying causes and refer as appropriate.
