Orthonotes
Orthonotes
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Hyperparathyroidism and Bone

Excess PTH causes cortical bone loss via RANKL-mediated osteoclast activation; classic radiology: subperiosteal resorption, salt‑and‑pepper skull, brown tumors. Primary (adenoma), secondary (CKD/vit D deficiency), tertiary (autonomous) forms dictate biochemistry and treatment. DEXA: cortical loss at one‑third radius; labs—↑PTH, ↑ALP; Ca high in primary/tertiary, low‑normal in secondary; phosphate low in primary, high in CKD. Orthopaedic issues: fragility fractures, brown tumors, tendon ruptures; treat endocrine cause first, then stabilize fractures as per principles. Parathyroidectomy is definitive for symptomatic primary disease; watch for hungry bone syndrome post‑op.

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Excess PTH causes cortical bone loss via RANKL-mediated osteoclast activation; classic radiology: subperiosteal resorption, salt‑and‑pepper skull, brown tumors. Primary (adenoma), secondary (CKD/vit D deficiency), tertiary (autonomous) forms dictate biochemistry and treatment. DEXA: cortical loss at one‑third radius; labs—↑PTH, ↑ALP; Ca high in primary/tertiary, low‑normal in secondary; phosphate low in primary, high in CKD. Orthopaedic issues: fragility fractures, brown tumors, tendon ruptures; treat endocrine cause first, then stabilize fractures as per principles. Parathyroidectomy is definitive for symptomatic primary disease; watch for hungry bone syndrome post‑op.
MCQs

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Question 1

What is the most characteristic radiological finding in hyperparathyroidism?

Question 2

Which of the following laboratory findings is typically associated with primary hyperparathyroidism?

Question 3

What is the definitive treatment for symptomatic primary hyperparathyroidism?

Question 4

Which condition represents the severe skeletal form of hyperparathyroidism characterized by cystic bone lesions?

Question 5

In secondary hyperparathyroidism due to chronic kidney disease, which of the following is typically observed?

Question 6

What is the 'hungry bone syndrome' that can occur post-parathyroidectomy?

Question 7

What is the common biochemical profile in a patient with primary hyperparathyroidism?

Question 8

Which of the following is a common orthopedic complication of hyperparathyroidism?

Question 9

What is the typical radiographic appearance of the skull in hyperparathyroidism?

Question 10

Which of the following is NOT a skeletal manifestation of hyperparathyroidism?