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NMF: Year 2 > calcium > Flashcards

calcium Flashcards

1
Q

How does hypocalcaemia present?

A

cramps
twitching
paraesthesiae

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2
Q

How does hypercalcaemia present?

A

BONES - bone pain, osteoporosis
STONES - renal stones
ABDO GROANS - pain, constipation, polyuria, polydipsia
PSYCHIC MOANS

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3
Q

What ECG change is seen in hypocalcaemia?

A

long QT

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4
Q

What can cause low calcium?

A

Kidney disease
Hypoparathyroidism
Vitamin D deficiency

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5
Q

What can cause high calcium?

A

malignancy
primary hyperparathyroidism
lithium
granulomas

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6
Q 
What is the 
a) PTH
b) Ca
c) PO4 
in primary hyperparathyroidism?
A

a) high PTH - as its overactive parathyroid
b) high ca - triggered by PTH
c) low phosphate

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7
Q

In which disease is there
high ALP
normal ca and po4?

A

paget’s disease

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8
Q

What is paget’s disease?

A

disease of bone remodelling

lots of osteoclasts break up bone then osteoblasts rebuild poor quality bone

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9
Q

What does low calcium trigger?

A

release of PTH by parathyroids

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10
Q

Why is calcium high in primary hyperparathryoid?

A

because it is inappropriate

the parathyroids are not working to detect the high calcium and continue to release PTH

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11
Q

Why is calcium low in secondary hyperparathyroid?

A

the high PTH is an appropriate response to a low calcium for other reasons eg kidney disease

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12
Q

Why is calcium very high in tertiary hyperparathyroid?

A

longstanding secondary hyperparathyrid causes hyperplasia and the levels of PTH stimulate bone resorption and high calcium

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13
Q 
What is the 
a) calcium
b) phosphate
c) ALP
d) PTH
in metastatic bone cancer?
A

a) high calcium
b)
c) high ALP
d) low PTH

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14
Q

raised ALP and high ca indicates?

A

bony mets

hyperparathyroid

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15
Q

raised ALP and low ca indicates?

A

osteomalacia

renal failure

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16
Q

What is osteomalacia?

A

defective mineralisation of bone often secondary to vit d deficiency

17
Q

How does osteomalacia present?

A 
muscle aches
weakness
bone pain
#
deformity
18
Q 
What is the 
a) calcium
b) phosphate
c) ALP
d) PTH
e) vit D 
level in osteomalacia?
A

a) low calcium
b) low phosphate
c) high ALP
d) high PTH
e) low vit D

19
Q 
What is the 
a) PTH
b) calcium
c) phosphate 
level in primary hypoparathyroid?
A

a) low
b) low
c) high

20
Q

what blood tests indicate a malignant hypercalcaemia?

A

high ca, ALP
low albumin
alkylosis

21
Q

what is the most important investigation in hypocalcaemia?

A

PTH

22
Q

What is found on blood tests for pagets?

A

normal calcium and phosphate, raised ALP

23
Q

What is found on blood test for osteomalacia?

A

low calcium and phosphate, raised PTH, raised ALP

NMF: Year 2 (12 decks)

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