Question 1

Which findings are symptoms of hyperparathyroidism? (Select all that apply.)&#10;A) Chvostek's sign&#10;B) Cognitive impairment&#10;C) Left ventricular hypertrophy&#10;D) Perioral paresthesias&#10;E) Renal calculi

Accepted Answer

B, C, E

Question 2

Which laboratory values representing parathyroid hormone (PTH) and serum calcium are consistent with a diagnosis of primary hyperparathyroidism?&#10;A) Appropriately high PTH along with hypocalcemia&#10;B) Appropriately increased PTH and low or normal serum calcium&#10;C) Inappropriate secretion of PTH along with hypercalcemia&#10;D) Prolonged inappropriate secretion of PTH with subsequent hypercalcemia

Accepted Answer

Primary hyperparathyroidism is caused by overproduction of PTH by one or more of the parathyroid glands. The laboratory values consistent with this diagnosis are an inappropriate secretion of PTH along with hypercalcemia, meaning that even though there is already a high serum calcium level, the parathyroid gland(s) continue to produce and release PTH. Option A, high PTH with hypocalcemia, is inconsistent with the diagnosis of primary hyperparathyroidism. Option B, increased PTH with low or normal serum calcium, may indicate secondary hyperparathyroidism, which is caused by a compensatory increase in PTH due to chronic hypocalcemia. Option D, prolonged inappropriate secretion of PTH with subsequent hypercalcemia, is redundant and does not provide additional information necessary for diagnosing primary hyperparathyroidism.

Question 3

A 40-year-old patient with primary hyperparathyroidism has increased serum calcium 0.5 mg/dL above normal without signs of nephrolithiasis. What is the recommended treatment for this patient?&#10;A) Annual monitoring of calcium, creatinine, and bone density&#10;B) Avoidance of weight-bearing exercises&#10;C) Decreasing calcium and vitamin D intake until values normal&#10;D) Parathyroidectomy

Accepted Answer

For a patient with primary hyperparathyroidism who has mildly increased serum calcium levels without symptoms such as nephrolithiasis, the recommended management is conservative, including regular monitoring of calcium, creatinine levels, and bone density to assess the progression of the disease and its impact on the body.

Deck 193: Parathyroid Gland Disorders