HYPERPARATHYROIDISM (Autosaved)

HYPERPARATHYROIDIS
M
PRESENTED BY
GABRIEL
DEFINITION
• Is a condition which occurs when the parathyroid glands
make too much parathyroid hormone(PTH)
• The parathyroid glands are four pea-sized endocrine glands
located in your neck, near or attached to that back of your
thyroid
• Endocrine glands secrete hormones necessary for the normal
functioning of the body.
• PTH helps regulate the levels of calcium, vitamin D, and
phosphorous in your bones and blood.
CONT,D
• Hyperparathyroidism, which is caused by

overproduction of parathormone by the
parathyroid glands, is characterized by bone
decalcification and the development of renal
calculi (kidney stones) containing calcium.
TYPES OF HYPERPARATHYROIDISM
1. PRIMARY HYPERPARATHYROIDISM
This occurs when you have a problem with at least one of your
parathyroid glands.
 Common causes include; benign growths on the gland
An increased risk of developing primary hyperthyroidism also occurs
in those who:
-have certain inherited disorders that affect several glands
throughout the body
-have a long history of calcium and vitamin D deficiencies
TYPES CONT’D
-have been exposed to radiation from cancer treatment
2. SECONDARY HYPERPARATHYROIDISM
This type occurs when you have an underlying condition that
causes your calcium levels to be abnomally low.
Most cases are due to;
-Chronic kidney failure
-Severe vitamin D deficiency
-severe calcium deficiency
TYPES CONT………..
3. TERTIARY HYPERPARATHYROIDISM
This type occurs when your parathyroid glands
keep making too much PTH after your calcium
levels return to normal.
 This type usually occurs in people with kidney
problems
PATHOPHYSIOLOGY
Primary Hyperparathyroidism
• In primary hyperparathyroidism, an abnormality
of the parathyroid glands causes inappropriate,
excess PTH secretion.
• The cause of primary hyperparathyroidism
ordinarily is a tumor of one of the parathyroid
glands.
PATHO CONT…
• Such tumors occur much more frequently in women
than in men or children, mainly because pregnancy
and lactation stimulate the parathyroid glands and
therefore predispose to the development of such a
tumor.
• Hyperparathyroidism causes extreme osteoclastic
activity in the bones.
PATHO CONT,D
• This elevates the calcium ion concentration in the
extracellular fluid while usually depressing the
concentration of phosphate ions because of
increased renal excretion of phosphate.
PATHO CONT..
Secondary Hyperparathyroidism
• In secondary hyperparathyroidism, high levels of
PTH occur as a compensation for hypocalcemia
rather than as a primary abnormality of the
parathyroid glands.
• This contrasts with primary hyperparathyroidism,
which is associated with hypercalcemia.
PATHO CONT..
• Secondary hyperparathyroidism can be caused by
vitamin D deficiency or chronic renal disease in
which the damaged kidneys are unable to
produce sufficient amounts of the active form of
vitamin D, 1,25-dihydroxycholecalciferol
SIGNS AND SYMPTOMS
• Symptoms can vary from mild to severe, depending on your type of
hyperparathyroidism.
Primary Hyperparathyroidism
• Some patients don’t have any symptoms. If you do have symptoms,
they can range from mild to severe. Milder symptoms may include:
• fatigue
• weakness
• depression
• body aches
SIGNS AND SYMPTOMS CONT…
More severe symptoms can include:
• appetite loss
• constipation
• vomiting
• nausea
• excessive thirst
• increased urination
• confusion
• memory problems
• kidney stones
S & S CONT…..
Secondary Hyperparathyroidism
• With this type, you may have skeletal abnormalities,
such as fractures, swollen joints, and bone deformities.
• Other symptoms depend on the underlying cause, such
as chronic kidney failure or severe vitamin D
deficiency.
How Is Hyperparathyroidism Diagnosed?
Blood Tests
• Additional blood tests can help your primary care
provider make a more accurate diagnosis.
• Your primary care provider will check your blood for
high PTH levels, high alkaline phosphatase levels, and
low levels of phosphorus.
TESTS CONT,D
Urine Tests
• A urine test can help your primary care provider
determine how severe your condition is and whether
kidney problems are the cause.
• Your primary care provider will check your urine to
see how much calcium it contains.
TESTS CONT’D
Kidney Tests
• Your primary care provider might take X-rays of your
abdomen to check for kidney abnormalities.
Ultrasound
MRI
MANAGEMENT
Hydration Therapy
• Because kidney involvement is possible, patients
with hyperparathyroidism are at risk for renal
calculi.
• Therefore, a daily fluid intake of 2000 mL or
more is encouraged to help prevent calculus
formation
MANAGEMENT CONT’D
Mobility
• Mobility of the patient, with walking or use of a
rocking chair for those with limited mobility, is
encouraged as much as possible, because bones that
are subjected to normal stress give up less calcium.
• Bed rest increases calcium excretion and the risk for
renal calculi.
MGNT CONT….
Diet and Medications
• Nutritional needs are met, but the patient is advised to avoid
a diet with restricted or excess calcium.
• If the patient has a coexisting peptic ulcer, prescribed
antacids and protein feedings are necessary.
• Because anorexia is common, efforts are made to improve the
appetite. Prune juice, stool softeners, and physical activity,
along with increased fluid intake, help offset constipation,
which is common postoperatively

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HYPERPARATHYROIDIS

• Hyperparathyroidism, which is caused by

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