In Secondary Hyperparathyroidism what happens to phosphorous and phosphate level

[cooldude89]

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In Secondary Hyperparathyroidism what happens to phosphorous and phosphate levels? Aren't they both the same so why is first aid say other wise? please explain..

 

[Jonari]

In Secondary Hyperparathyroidism what happens to phosphorous and phosphate levels? Aren't they both the same so why is first aid say other wise? please explain..

Which year are you using? If it's 2012, what page? Check the FA errata for the year you're using, as it is a typo. In secondary hyperPTH, phosphate levels will be elevated.

 

[cooldude89]

page 327 2012 edition it says inc phosphorus and hyperphosphatemia, but in a uworld questions i read phosphate should decrease because of inc PTH release...

 

[Jonari]

page 327 2012 edition it says inc phosphorus and hyperphosphatemia, but in a uworld questions i read phosphate should decrease because of inc PTH release...

Well, it doesn't show up on the 2012 Errata - http://firstaidteam.com/wp-content/uploads/FA-Step-1-2012-errata-120730.pdf

UWorld is incorrect. With 2ndary hyperPTH, the underlying reason is that you can't activate Vitamin D. This leads to a decrease in absorption of calcium and phosphate from the intestines --> leading to PTH release --> however since the kidneys aren't working properly they can't "trash phosphate". In addition, phosphate binds to the free circulating calcium, dropping free calcium levels while elevating the phosphate levels --> repeat cycle.