Hypoparathyroidism

Question 1

causes

Answer 1

congenital absence (DiGeorge syndrome)
destruction (surgery, radiotherapy and malignancy)
AI (can have other AI associations e.g. vitiligo and hypomagnesaemia)

Question 2

presentation

Answer 2

• tetany= neuromuscular irritability
• fractures
• altered mental state (emotional lability, anxiety, depression, confusion and psychosis)
• calcification of lens and cataract formation
• prolonged QT interval
• dental abnormalities

Question 3

diagnosis

Answer 3

low calcium, low PTH and high serum phosphate
idiopathic antibodies
Chvostek’s sign
Trousseau’s sign

Question 4

management

Answer 4

calcium supplements

vitamin D tablets (alphacalcidol and cholecalciferol)

Question 5

cause of pseudohypoparathyroidism

Answer 5

genetic defect in Gs alpha subunit (gene GNAS1) leading to low calcium and normal/high PTH
there is abnormality in the PTH receptor leading to resistance

Question 6

presentation of pseudohypoparathyroidism

Answer 6

McCune Albright
obesity
subcutaenous calcification 
learning disability
BUZZWORD= brachydactyly 4th metacarpal

Question 7

diagnosis of pseudohypoparathyroidism

Answer 7

low calcium
high PTH
high phosphate

Question 8

pseudo- pseudohypoparathyroidism

Answer 8

albright’s hereditary osteodystrophy but no alteration in PTH