PAEA Surgery End Of Rotation (EOR) Practice Exam

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What condition is marked by increased secretion of PTH and elevated calcium levels?

Secondary hyperparathyroidism
Hypoparathyroidism
Hyperparathyroidism
Primary hyperparathyroidism

The correct answer is: Hyperparathyroidism

The condition characterized by increased secretion of parathyroid hormone (PTH) and elevated calcium levels is primary hyperparathyroidism. This condition typically arises from an adenoma of one of the parathyroid glands, resulting in excessive production of PTH. The elevated levels of PTH lead to increased renal tubular calcium reabsorption, increased intestinal calcium absorption (due to enhanced vitamin D metabolism), and increased mobilization of calcium from bones. The net effect of these mechanisms is hypercalcemia. Additionally, primary hyperparathyroidism often presents with classic symptoms and signs, including nephrolithiasis (kidney stones), osteitis fibrosa cystica (bone changes), and gastrointestinal disturbances such as constipation. It is crucial to differentiate it from other parathyroid conditions, as secondary hyperparathyroidism is typically associated with low calcium levels due to chronic kidney disease or vitamin D deficiency, causing elevated PTH in response. Hypoparathyroidism involves low calcium levels and low PTH secretion, which is the opposite of the conditions being considered.