Endocrine & metabolic · UKMLA & AKT

Secondary hyperparathyroidism

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise secondary hyperparathyroidism — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Secondary HPT = reactive, compensatory PTH rise due to extraglandular cause (most commonly CKD) - NOT autonomous overproduction
  • Secondary HPT causes parathyroid hyperplasia (all four glands) - contrast with primary HPT which is almost always a solitary adenoma (85%)
  • "Secondary" in hyperparathyroidism = renal disease; "secondary" in hypoparathyroidism = surgical/radiation damage; "secondary" in hypothyroidism = pituitary/hypothalamic cause

Secondary HPT produces hypocalcaemia symptoms (paraesthesia, cramps, tetany) - NOT hypercalcaemia symptoms (stones, bones, groans, moans). This is the key clinical differentiator from primary HPT.

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Related UKMLA topics

Primary hyperparathyroidismAcromegalyHyperosmolar hyperglycaemic state (HHS)Diabetes insipidusDiabetic ketoacidosis (DKA)Graves disease (including thyroid eye disease)