The video version of this podcast can be found here: · https://youtu.be/Mx9iVonx61QThis episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.NICE stands for "National Institute for Health and Care Excellence" and is an independent organization within the UK healthcare system that produces evidence-based guidelines and recommendations to help healthcare professionals deliver the best possible care to patients, particularly within the NHS (National Health Service) by assessing new health technologies and treatments and determining their cost-effectiveness; essentially guiding best practices for patient care across the country.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I go through the NICE guideline on Primary Hyperparathyroidism, focusing on what is relevant to Primary Care only. Make sure to stay for the entirety of the episode because, at the end, I will also explain the pathophysiology of secondary and tertiary hyperparathyroidism.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The Full NICE guideline Hyperparathyroidism (primary): diagnosis, assessment and initial management or [NG132] can be found here:· https://www.nice.org.uk/guidance/ng132TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we are looking at the NICE guideline on Primary Hyperparathyroidism, or NG132, focusing on what is relevant to Primary Care only. Make sure to stay for the entirety of the episode because, at the end, I will also touch on secondary and tertiary hyperparathyroidism.Right, let’s jump into it.What features could indicate primary hyperparathyroidism?Well, experience suggests that hypercalcaemia in primary hyperparathyroidism is commonly associated with symptoms such as thirst, frequent or excessive urination, and constipation, and with conditions such as osteoporosis, fragility fractures and renal stones. So, these are the prime clues to look for.However, sometimes there are also chronic non-specific symptoms, including fatigue, anxiety and depression, confusion, irritability and digestive problems.And, of course, primary hyperparathyroidism can also be asymptomatic showing simply as hypercalcaemia. Hypercalcaemia is defined as a corrected calcium of 2.6 mmol/litre or more. What diagnostic testing should we do in primary care?The main initial test is the albumin-adjusted serum calcium, which, from now on and for simplicity, I will refer to as just corrected calcium. We should not rely on ionised calcium. This is because calcium that is bound to albumin is not active and does not have clinical effects, so adjusting for albumin is a better measurement. Furthermore, ionised calcium is not subject to the same stringency of laboratory testing and the sample has to be ...
