Calcium approach Flashcards

1
Q

2 main forms of Ca levels

A
  1. albumin bound - down with low albumin

2. free -the one that counts

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2
Q

3 main controls of Ca

A
  1. PTH - up Ca, down phos
  2. Calcitonin - down Ca, down phos
  3. vit D - up Ca, up phos
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3
Q

11 causes of low Ca

A
  1. hypoparathyroid - most common
  2. acute panc - Ca desposition
  3. renal insuff. - low vit D production
  4. hyperphos - precipitates together, leading to low Ca
  5. pseudohypopara - hereditary insens. to PTH
  6. hypomag - lower PTH secretion
  7. vit. D def.
  8. malabsorption
  9. blood transfusions
  10. osteoblastic mets
  11. hypoalbuminemia
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4
Q

clinical Sx of low Ca

A
  1. none
  2. rickets and osteomalacia
  3. neuromusc irritibility
    - numbness/tingling
    - tetany -hyperactive reflexes, Chostek sign
    - grand mals
  4. basal ganglia calcifications
  5. cardiac manifestations
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5
Q

Dx of hypo Ca

A

1bloods

  • BUN, Cr, Mg, albumin, Ca
    2. serum PO4
    3. PTH
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6
Q

Tx of low Ca

A
  1. IV Ca gluconate

2. oral Ca and vit D

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7
Q

4 general causes of hyper Ca

A
  1. endo
  2. drugs
  3. malig
  4. other
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8
Q

4 endo causes

A
  1. hyperpara
  2. renal failure
    - usually get hypo, but can get rebond PTH enough to raise
  3. paget’s disease
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9
Q

3 major malig

A
  1. bone mets
  2. multiple myeloma
  3. PTH tumors (small cell lung)
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10
Q

3 major drug issues

A
  1. vit. D tox
  2. milk alkali syndrome
  3. drugs
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11
Q

5 major clinical Sx

A
  1. Stones
  2. Bones
    - aches and pains
  3. groans
    - muscle pain and weakness
    - PUD, pancreatitis
  4. psych overtones
    - depression, fatigue
  5. other
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12
Q

Dx tests of hyper

A
  1. same as hypo
  2. PTH radioimmunoassay
  3. bone scan
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13
Q

Tx of hyper

A
  1. IV fluids and lasix
  2. bisphosphonates and calcitonin
  3. steroids if Vit D related
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