Hyperparathyroidism

excess of
parathyroid
hormone in the
bloodstream due to of
one or more of the
body's four
parathyroid glands.
Primary:

Intrinsic gland
dysfunction
an enlargement of
one or more of the
parathyroid glands
causing
overproduction and
high calcium blood
levels (hypercalcemia)

Secondary:

Gland hyperactivity
from hypocalcemia
or Vit D deficiency
result of another
disease that causes
low levels of
calcium in the body.

symptoms

75% are
Asymptomatic
Classic complaints:
Painful bones
Renal stones
Abdominal groans
Psychic moans

signs

Hypertension
Band Keratopathy
band
across eye
Osteoporosis
Atrophy of proximal
muscles

labs

Elevated serum
calcium levels
(fasting)
Primary
Hypercalcemia +
Increased intact PTH
+ Decreased
Phosphate
Secondary

TX

Hyperthyroidism

Hypothyroidism

Increased PTH,
hypocalcemia, vit D
deficiency
Primary
Surgery
Treat hypercalcemia
if symptomatic (IV
fluids, furosemide,
calcitonin)
bisphosphonates
Secondary
Vit D/Calcium
supplementation if
secondary

Graves
Toxic multinodular
goiter
Toxic adenoma
TSH Secreting
Pituitary adenoma
Symptoms

Fatigue
Weakness
Heat Intolerance
Palpitations
Nervousness
Emotional lability

lab

Thyroid Function
Tests
Examples
Low TSH
High Serum T3, T4
RAIU (Uptake on
scan)

TX

First line tx
Methimazole
Propylthiouracil
Beta Blockers
(propanolol)
Surgery

Hashimotos
Silent (lymphocytic)
Post-partum
De Quervains
Medication induced
Thyroiditis

Symptoms

Weakness, fatigue,
lethargy
Cold Intolerance
Decreased memory
Constipation
Modest weight gain
Depression
Dry skin

signs

Dry coarse skin

Dull facial expression
Husky voice
Delayed deep tendon
reflexes
Reduced body and
scalp hair
Increased weight
Cold intolerance

LABS

Thyroid Function
Tests
Examples
High TSH
Low Serum T3, T4
Thyroid antibodies

TX

Levohyroxine
(synthroid)