Diseases of the (para)thyroid glands

I recently found a nice letter-to-the-editor entitled “Mnemonics for endocrinologists: hyperparathyroidism” written by Janusz Myśliwiec in a Polish endocrinology journal which provided 3 mnemonics for hyperparathyroidism. The first mnemonic is for remembering the etiology of hypercalcemia: RHINOS.

R = Renal insufficiency (i.e. secondary and tertiary hyperparathyroidism)
H = Hyperparathyroidism (i.e. primary hyperparthyroidism)
I = Immobilisation and iatrogenic (overdose of calcium/vitamin D, thiazides)
N = Neoplasms (bone mets, bone cancers, paraneoplastic)
O = Other endocrinopathies (thyrotoxicosis, Addison’s disease)
S = Sarcoidosis

The second mnemonic describes the clinical presentation of hyperparathyroidism (which is essentially the presentation of hypercalcemia): “Stones, bones, abdominal groans and psychiatric overtones”

Stones = Kidney stones/nephrocalcinosis/renal failure and biliary stones
Bones = Bone pain (osteitis fibrosa cystica, osteoporosis, osteomalacia)
Abdominal groans = GI symptoms of nausea, vomiting, constipation
Psychiatric overtones = Psychosis, anxiety, lethargy, memory loss, depression, coma

The third mnemonic is a more extensive description of the same clinical picture: “PARAT-HORMONE”

P = Poor bones
A = Abdominal pain
R = Renal stones (nephrocalcinosis and renal failure)
A = Altered mental state
T = Thirst (i.e. polydipsia due to polyuria)

H = Hypertension (50% of patients)
O = Ocular calcifications (and other tissue calcifications)
R = von Recklinghausen’s osteitis fibrosa cystica
M = Muscle weakness
O = Other MEN1 and MEN2a components
N = Non-normal lab values (high calcium/parathormone/alkali phosphatase and low phosphate)
E = Electrocardiogram (shortened QT and bradycardia, increased sensitivity to digitalis and risk of asystole)

Last but not least, thanks to Leah for submitting the following mnemonic for “hyperTHYROIDISM”

T = Tremor
H = Heart rate (increased)
Y = Yawning (fatigue)
R = Restlessness
O = Oligomenorrhea/amenorrhea
I = Irritability
D = Diarrhea
I = Intolerance to heat
S = Sweating
M = Muscle wasting/weight loss


Thanks for reading! Happy studying!

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