Hypoparathyroidism

Assessments



When assessing a patient for possible indications of hypoparathyroidism, its important to ask the patient about any of the subjective signs and sypmtoms, such as fatigue, nervousness, or anxiety, as well as looking for them during the exam. Hypoparathyroidism usually is asymptomatic for patinets. Other things, besides signs and symptoms, to look for if the person has hypoparathyroidism are...
  • atrophy of the nails
  • enamel defects and hypoplasia of teeth
  • monitor patient for possible dysrythmias that might occure due to hypocalcemia
  • shortened metacarpals/metatarsals occur with pseudohypoparathyroidism
  • possible surgical scar on the neck from thyroid surgery

Diagnostics

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Diagnostics are used to help definitively diagnos hypoparathyroidism some tests that would be run to confirm diagnosis are...

Blood tests
  • calcium levels
  • phosphorus levels
  • magnesium levels
  • PTH levels
EKG
  • monitor for any dysrhythmias that might occure
  • prolongation of ST and QTc intervals (figure 1)
  • non-specific repolarization changes
Urine test
  • used to determine how much calcium the kidneys are excreting
X-ray
  • may need to have one done because patient may have pathological fractures
Diagnosis is made when hypocalcemia is found as well as low levels of PTH. When making the diagnosis of hypoparathyroidism, the doctors need to rule out pseudohypoparathyroidism, hungry bones syndrome, osteoblastic metastasis, renal failure, hypoalbuminemia, malabsorption, calcium chelators because these diseases decrease calcium levels as well and can aprear to act like hypoparathyroidism, but the treatments for these diseases can be different then the diagnosis of hypoparathyroidism.

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Figure 1