USMLE/COMLEX - Step 2 - Hyperparathyroidism

USMLE/COMLEX - Step 2 - Hyperparathyroidism Hyperparathyroidism is when the parathyroid glands produce too much parathyroid hormone (PTH), which regulates the levels of calcium, phosphate, and vitamin D in the body. There are three types of hyperparathyroidism: primary, secondary, and tertiary. Primary hyperparathyroidism occurs due to a benign tumor on one of the parathyroid glands, leading to excess PTH production and subsequent hypercalcemia. Secondary hyperparathyroidism occurs when the parathyroid glands produce excess PTH in response to low calcium levels in the blood, often due to chronic kidney disease or vitamin D deficiency. Finally, tertiary hyperparathyroidism occurs when the parathyroid glands continue to produce excess PTH even after the underlying cause of secondary hyperparathyroidism has been corrected. Fatigue Weakness Depression Bone pain or fractures Abdominal pain Nausea and vomiting Constipation Loss of appetite Excessive thirst and urination Memory loss and difficulty concentrating Hypertension Increased bone tenderness and pain loss of bone density Kidney stones Muscle weakness Pancreatitis Cardiac arrhythmias Serum calcium, phosphate, and parathyroid hormone levels 24-hour urine analysis Bone density scan X-rays Sestamibi scan or a parathyroid scan Biopsy of any suspected tumors or abnormal tissues The treatment for hyperparathyroidism depends on the underlying cause and the severity of the condition: 1. Primary hyperparathyroidism: The treatment for primary hyperparathyroidism is surgery to remove the abnormal parathyroid gland(s). It is usually a safe and effective procedure with a high success rate in curing the condition. 2. Secondary hyperparathyroidism: The treatment for secondary hyperparathyroidism depends on the underlying cause. For example, if the condition is due to chronic kidney disease, treatment may involve controlling the underlying kidney disease and supplementing vitamin D and calcium as necessary. 3. Tertiary hyperparathyroidism: The treatment for tertiary hyperparathyroidism may involve surgery to remove the abnormal parathyroid gland(s), similar to primary hyperparathyroidism.