Ca Metabolism & Disorders Flashcards
hypercalcaemia aetiology…
1y: drugs, granulomatous disease, familial hypocalciuric hypercalcaemia, Paget’s, 3y hyperparathyroidism
s/s of hypercalcaemia
bones, stones, abdominal groans, psychic moans
acute: polydipsia, polyuria
chronic: fractures, myopathy
ix for hypercalcaemia
high PTH > check Ur Ca:
high= 1y/3y hyperparathyroidism
low= FHH
low PTH= bone pathology so check ALP:
high ALP= mets, thyrotoxicosis
low ALP= myeloma, vitD
tx for hypercalcaemia
acute: fluids, loop diuretics, bisphosphonates
chronic: surgery, cinacalacet
what is hyperparathyroidism
excess secretion of Ca from parathyroid glands due to pathology
what familial condition can cause hyperparathyroidism
MEN1/2
types of hyperparathyroidism
1y: overactive PT gland (e.g. adenoma)
2y: physiological response to low Ca/ vita
3y: PT gland becomes autonomous after many years of overactivity
ix for hyperparathyroidism
biochemistry: PTH & SrCa
1y: high Ca, high PTH
2y: low Ca, high PTH
3y: high Ca, high PTH
mx for hyperPT
surgery, cinacalcet
hypocalcaemia main aetiology
hypoparathyroidism
s/s of hypocalcaemia
paraesthesia, muscle cramps, tetany, muscle weakness, fatigue, bronchospasm
prolonged QT on ECG
what are the 2 signs associated with hypocalcaemia
Chovsteks’s sign: burning when tapping over facial nerve
Trousseau sign: carpopedal spasm
mx of hypocalcaemia
IV Ca Gluconate- 10ml, 10%, 3 min
aetiology of hypoparathyroidism
congenital absence (Di George Syndrome), iatrogenic destruction, AI, hypoMg (alcohol, drugs)
mx for hypoparathyroidism
Ca and VitD tablets
what is pseudohypoparathyroidism
low Ca, high PTH due to PTH resistance
what is pseudohypoparathyroidism due to
GNAS1 defect
s/s of pseudohypoparathyroidism
bone abnormalities, obesity, brachdactylyl
vitD deficiency causes
diet def, renal failure, malabsorption, lack of sunlight, anticonvulsants
tx for vitD def
vitD tablets, Ca tablets
