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A Grumpy Old Man

Hypercalcemia and the Parathyroid Glands


Sheri L. Boyce
Department of Biological Sciences
Messiah College


This directed case study tells the story of an 84-year-old man who has been brought to the ER for treatment of a badly broken wrist. Routine bloodwork reveals his calcium levels are abnormal, which prompts more tests. The results, together with his behavior and medical history, indicate that his fracture might be due to an endocrine disorder and not simply the result of a fall. Students will investigate which component of the endocrine system is involved, and how his calcium levels are the result of gland dysfunction. They are also asked to draw on their understanding of negative feedback control to predict if hormone secretion is abnormally elevated or decreased. Finally, students consider how a disruption in calcium homeostasis results in the patient's signs and symptoms. The case was written for a two-semester anatomy and physiology course taken by nursing, nutrition, athletic training, and other allied health majors in their first or second year. Alternatively, it could be adapted for use in a high school anatomy and physiology course, or an upper-level physiology or pathophysiology course.

  • Describe the parathyroid glands in terms of their location and the hormone secreted.
  • Describe the physiological actions of parathyroid hormone.
  • Understand the control of parathyroid hormone secretion via negative feedback.
  • Explain the physiology underlying the signs and symptoms of primary hyperparathyroidism.
Keywords: Calcium; parathyroid gland; hyperparathyroidism; endocrine; homeostasis; negative feedback; pHPT; PTH
Topical Area: N/A
Educational Level: High school, Undergraduate lower division, Undergraduate upper division
Formats: PDF
Type/Method: Directed, Discussion
Language: English
Subject Headings: Physiology   Medicine (General)  
Date Posted: 8/22/2019
Date Modified: N/A
Copyright: Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

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