Calcium approach Flashcards
1
Q
2 main forms of Ca levels
A
- albumin bound - down with low albumin
2. free -the one that counts
2
Q
3 main controls of Ca
A
- PTH - up Ca, down phos
- Calcitonin - down Ca, down phos
- vit D - up Ca, up phos
3
Q
11 causes of low Ca
A
- hypoparathyroid - most common
- acute panc - Ca desposition
- renal insuff. - low vit D production
- hyperphos - precipitates together, leading to low Ca
- pseudohypopara - hereditary insens. to PTH
- hypomag - lower PTH secretion
- vit. D def.
- malabsorption
- blood transfusions
- osteoblastic mets
- hypoalbuminemia
4
Q
clinical Sx of low Ca
A
- none
- rickets and osteomalacia
- neuromusc irritibility
- numbness/tingling
- tetany -hyperactive reflexes, Chostek sign
- grand mals - basal ganglia calcifications
- cardiac manifestations
5
Q
Dx of hypo Ca
A
1bloods
- BUN, Cr, Mg, albumin, Ca
2. serum PO4
3. PTH
6
Q
Tx of low Ca
A
- IV Ca gluconate
2. oral Ca and vit D
7
Q
4 general causes of hyper Ca
A
- endo
- drugs
- malig
- other
8
Q
4 endo causes
A
- hyperpara
- renal failure
- usually get hypo, but can get rebond PTH enough to raise - paget’s disease
9
Q
3 major malig
A
- bone mets
- multiple myeloma
- PTH tumors (small cell lung)
10
Q
3 major drug issues
A
- vit. D tox
- milk alkali syndrome
- drugs
11
Q
5 major clinical Sx
A
- Stones
- Bones
- aches and pains - groans
- muscle pain and weakness
- PUD, pancreatitis - psych overtones
- depression, fatigue - other
12
Q
Dx tests of hyper
A
- same as hypo
- PTH radioimmunoassay
- bone scan
13
Q
Tx of hyper
A
- IV fluids and lasix
- bisphosphonates and calcitonin
- steroids if Vit D related