Endocrine & metabolic · UKMLA & AKT
Secondary hyperparathyroidism
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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