Hyperparathyroid

Question 1

Clinical Features

Answer 1

Bone pain, fragility fractures, ↓BMD
Nephrolithiasis, Nephrocalcinosis, polyuria, renal insufficiency
Nausea, Vomiting, PUD, constipation, pancreatitis
Lethargy, decreased cognition, depressed mood, psychosis, coma
Gout, pseudo gout
LV Hypertrophy, ↓QT interval

Question 2

DDx

Answer 2

Vit D Deficiency
Chronic Renal Insufficiency 
TSH
Malignancy
Adrenal Insufficiency

Question 3

Risk Factors

Answer 3

Age > 50
F > M
Meds: Thiazide, Lithium
Radiation to neck, radioactive iodine 
Genetic: MEN Type 1 + Type 2A, Familial Hypocalciuric Hypercalcemia, Familial Hyperparathyroidism – jaw tumor syndrome, Neonate severe hyperparathyroidism, Familial isolated hyperparathyroidism

Question 4

Investigations

Answer 4

PTH
Ca
Albumin

Question 5

Management of Primary Hyperparathyroidism

Answer 5

Volume Repletion
Loop Diuretics once euvolemic
Pamidronate or Zolindronate
Parathyroidectomy