USMLE/COMLEX - Step 2 - Hypoparathyroidism

USMLE/COMLEX - Step 2 - Hypoparathyroidism Hypoparathyroidism is characterized by the parathyroid glands' inadequate production or secretion of parathyroid hormone (PTH). This hormone regulates the body's calcium, phosphorus, and vitamin D levels. The pathophysiology of hypoparathyroidism involves disruption in the normal feedback loop that regulates PTH secretion, resulting in a deficiency of this hormone. Neuromuscular irritability leading to muscle cramps, twitching, and tetany Numbness, tingling, or burning sensations in the hands, feet, or face Seizures or convulsions Abnormal heart rhythms Dry, scaly skin or hair loss Tooth decay and brittle nails Blurred vision problems Chvostek's sign Trousseau's sign Dry, scaly skin or brittle nails Cataracts or other vision problems Hypocalcemic seizures or convulsions Arrhythmias Tachycardia Neuropathy Serum calcium, phosphorus, and parathyroid hormone Urinalysis Electrocardiogram Genetic testing Ultrasound, CT scan, or MRI Treating hypoparathyroidism involves correcting the imbalance of calcium and phosphorus in the body and addressing any underlying causes. Treatment options may include the following: 1. Calcium and vitamin D supplementation: Calcium and vitamin D supplements increase serum calcium levels and maintain bone health. They may be given orally or via injections. 2. Active vitamin D supplements: In some cases, active vitamin D supplements such as calcitriol or alfacalcidol may enhance calcium absorption from the gut and kidneys. 3. Magnesium supplementation: Magnesium supplements may be given in cases where hypomagnesemia (low magnesium levels) contributes to hypoparathyroidism. 4. Diet modification: A low-phosphorus diet may be recommended to help reduce phosphorus absorption and avoid calcium-phosphorus imbalances. 5. Treatment of underlying conditions: Treatment of underlying conditions such as autoimmune disorders or genetic mutations may be necessary. 6. Parathyroid hormone replacement therapy: For severe cases of hypoparathyroidism, parathyroid hormone replacement therapy may be necessary to help restore calcium and phosphorus balance.