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hypoparathyroidism basic

Published in: Health & Medicine
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  1. 1. -sinthu sarathamani
  2. 2. Hypoparathyroidism is decreased function of the parathyroid DEFINITION glands with underproduction of parathyroid hormone
  3. 3. calcium phosphorous
  4. 4. absence of a pair of chromosome 22 Etiology unknown; sporadic (nonhereditary); onset before age 20 years; external ophthalmoplegia; complete heart block.
  5. 5. Increased neuromuscular irritability Including: • Paresthesias (lips, tongue, fingers, feet) • Muscle cramps • Weakness • Headaches • Carpopedal spasms
  6. 6. Acute presentation may include: • Tetany • Seizures • Altered mental state • Congestive heart failure • Stridor
  7. 7. Symptoms of longstanding hypoparathyroidism include: Cataracts Malformations of teeth Intracranial calcifications Renal stones Renal failure
  9. 9. DIAGNOSTIC SIGNS Chvostek’s Trousseau’s signs
  10. 10. Chvostek’s sign An abnormal reaction to the stimulation of the facial nerve. When the facial nerve is tapped at the angle of the jaw (i.e. masseter muscle), the facial muscles on the same side of the face will contract momentarily (typically a twitch of the nose or lips) because of hypocalcemia
  11. 11. To elicit the sign, a blood pressure cuff is placed around the arm and inflated to a pressure greater than the systolic blood pressure and held in place for 3 minutes. This will occlude the brachial artery. In the absence of blood flow, the patient's hypocalcemia and subsequent neuromuscular irritability will induce spasm of the muscles of the hand and forearm. The wrist and metacarpophalangeal jointsflex, the DIP and PIPjoints extend, and the fingers adduct
  12. 12. Investigations
  13. 13. • Primary • hypoparathyroidism PTH ca • Secondary hypoparathyroidism PTH ca • Serum • PTH and ca levels
  14. 14. Measurement of 25-hydroxy vitamin D • to exclude vitamin D deficiency as a cause of hypocalcemia. Serum magnesium • Hypomagnesemia may cause PTH deficiency and subsequent hypocalcemia Serum phosphorus • PTH is a phosphaturic hormone. In its absence, phosphorus levels in the blood rise.
  15. 15. Medication Surgical Care Consultations Diet
  16. 16. MEDICATION Calcium salts and vitamin D are the mainstays of treatment. CALCIUM SALTS: Calcium carbonate Calcium citrate Calcium gluconate Vitamin D preparations Ergocalciferol Dihydrotachysterol Calcifediol Calcitriol
  17. 17. SURGICAL CARE • Patients undergoing parathyroidectomy for parathyroid hyperplasia are at high risk of developing permanent primary hypoparathyroidism. • Patients may be treated with an autotransplant of a segment of parathyroid gland to prevent hypoparathyroidism.[5] This autotransplant is usually placed subcutaneously in the forearm or in the neck. • If the autotransplantation fails, patients receive the same treatment that is administered to other patients with hypoparathyroidism.
  18. 18. Consultations An endocrinologist should be involved in the care of all patients who have primary hypoparathyroidis m or who are at risk of developing it Diet A diet rich in calcium content (ie, emphasizing dairy products) is recommended for patients with primary hypoparathyroi dism.
  19. 19. “What is success? It is being able to go to bed each night with your soul at peace” -Paulo coelho
  20. 20. THANK YOU