Endocrine & metabolic · UKMLA & AKT
Primary hyperparathyroidism
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise primary hyperparathyroidism — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Solitary parathyroid adenoma - 85%; most common cause
- Multiglandular hyperplasia - 10-12%; often familial (MEN1, MEN2A)
- Multiple adenomas - 4-5%
- Parathyroid carcinoma - <1%; causes markedly elevated PTH and severe hypercalcaemia
Why is phosphate LOW? PTH increases renal phosphate excretion - the renal wasting effect dominates over bone resorption release, giving net hypophosphataemia. This distinguishes primary HPT (low phosphate) from secondary HPT in CKD (high phosphate).
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