NCM116 PARATHYROID

What is hyperparathyroidism?

Excess secretion of PTH leading to hypercalcemia and hypophosphatemia.

What is hypoparathyroidism?

Deficient PTH secretion causing hypocalcemia and hyperphosphatemia.

What is the main function of PTH?

Increases serum calcium via bone resorption renal reabsorption and vitamin D activation.

Where are the parathyroid glands located?

Posterior to the thyroid gland usually four small glands.

How does PTH affect phosphate levels?

Decreases phosphate by increasing renal excretion.

What hormone works synergistically with PTH?

Vitamin D.

What regulates PTH secretion?

Serum calcium levels via negative feedback.

What happens to neuromuscular activity in hypocalcemia?

It increases leading to tetany.

What happens to neuromuscular activity in hypercalcemia?

It decreases leading to weakness.

What is the normal serum calcium range?

Approximately 8.5 to 10.5 mg per dL.

What is the most common cause of primary hyperparathyroidism?

Parathyroid adenoma.

What causes secondary hyperparathyroidism?

Chronic kidney disease.

What is a classic mnemonic for hyperparathyroidism symptoms?

Bones stones groans and psychiatric overtones.

Why do kidney stones occur in hyperparathyroidism?

Due to increased calcium excretion in urine.

Why do bones weaken in hyperparathyroidism?

Increased osteoclast activity causing bone resorption.

What GI symptoms occur in hyperparathyroidism?

Nausea vomiting constipation peptic ulcers.

What cardiovascular effects occur in hyperparathyroidism?

Hypertension and cardiac dysrhythmias.

What psychological symptoms occur in hyperparathyroidism?

Depression irritability psychosis.

What lab findings confirm hyperparathyroidism?

Increased calcium increased PTH decreased phosphate.

What ECG change is seen in hypercalcemia?

Shortened QT interval.

What imaging is used to localize parathyroid adenoma?

Ultrasound or sestamibi scan.

What is hypercalcemic crisis?

Severe hypercalcemia above 15 mg per dL causing life threatening symptoms.

What is the emergency treatment for hypercalcemic crisis?

IV fluids and loop diuretics.

Why are loop diuretics used in hypercalcemia?

They increase calcium excretion.

What drug inhibits bone resorption in hyperparathyroidism?

Bisphosphonates.

What hormone rapidly lowers calcium levels?

Calcitonin.

What is the definitive treatment for primary hyperparathyroidism?

Parathyroidectomy.

What is a key nursing priority in hyperparathyroidism?

Prevent fractures and kidney stones.

Why is hydration important in hyperparathyroidism?

Prevents renal calculi formation.

Why is mobility encouraged in hyperparathyroidism?

Reduces bone calcium loss.

What is the most common cause of hypoparathyroidism?

Thyroid or neck surgery.

What is the hallmark symptom of hypoparathyroidism?

Tetany.

What causes tetany?

Hypocalcemia increasing neuromuscular excitability.

What is Chvostek sign?

Facial twitch when tapping the facial nerve.

What is Trousseau sign?

Carpopedal spasm induced by blood pressure cuff inflation.

What respiratory complication can occur in hypoparathyroidism?

Laryngospasm.

What neurological symptoms occur in hypoparathyroidism?

Seizures irritability confusion.

What ECG change occurs in hypocalcemia?

Prolonged QT interval.

What lab findings confirm hypoparathyroidism?

Low calcium low PTH high phosphate.

At what calcium level does tetany occur?

Less than or equal to 5 to 6 mg per dL.

What is the first line emergency treatment for hypocalcemia?

IV calcium gluconate.

What is long term treatment for hypoparathyroidism?

Oral calcium and vitamin D supplementation.

Why is vitamin D given in hypoparathyroidism?

Enhances calcium absorption in the gut.

Why must magnesium be monitored in hypoparathyroidism?

Low magnesium impairs PTH secretion.

What is the nursing priority in hypoparathyroidism?

Maintain airway and prevent seizures.

What is the key calcium difference between the two conditions?

Hyperparathyroidism causes high calcium hypoparathyroidism causes low calcium.

What is the neuromuscular difference between the two conditions?

Hyperparathyroidism causes weakness hypoparathyroidism causes spasms.

What patient history suggests hypoparathyroidism?

Recent thyroidectomy with tingling or muscle cramps.

What patient history suggests hyperparathyroidism?

Kidney stones and bone pain.

What is an important exam tip about calcium levels?

Low calcium causes spasms high calcium causes weakness.

What complication can untreated hyperparathyroidism lead to?

Renal failure and severe bone demineralization.

What complication can untreated hypoparathyroidism lead to?

Seizures laryngospasm and cardiac arrhythmias.