Calcium Disorders Flashcards
what are the symptoms of acute hypercalcaemia?
thirst, dehydration, confusion and polyuria
what are the symptoms of chronic hypercalcaemia?
myopathy, osteopenia, fractures, depression, hypertension, abdominal pain, pancreatitis, ulcers and renal stones.
‘Stones, groans, bones and psychic moans’
what is the main test for hypercalcaemia?
PTH (parathyroid hormone)
what are the two main causes of hypercalcaemia?
primary hyperparathyroidism and malignancy
how do we diagnose primary hyperparathyroidism?
raised serum calcium, raised PTH, increased urine calcium
how does malignancy cause hypercalcaemia?
bone destruction, PTH related protein from solid tumours, osteoclast activation
how do we diagnose hypercalcaemia of malignancy?
raised calcium and ALP, X-ray, CT and MRI. isotope bone scan. suppressed PTH
what are the indication for parathyroidectomy?
end organ damage, high calcium, under 50, epidermal growth factor receptor low
what is primary hyperpara? how would this show on results?
primary overactivity of parathyroid e.g. adenoma. results = PTH up, Ca up
what is secondary hyperpara? how would this show on results?
physiological response to low calcium.
Results = Ca low, PTH up
what is tertiary hyperpara? how would this show on results?
parathyroid becomes autonomous after many years of secondary.
Results = Ca up, PTH up
what is hypocalciuric hypercalcaemia?
familial hypercalcaemia, usually asymptomatic
some general symptoms of hypocalcaemia?
paraesthesia, muscle cramps/weakness, fatigue, bronchospasm, fits,
what ecg sign can indication hypocalcaemia?
QT prolongation
what is Chovsteks sign?
tapping over the facial nerve
what is trousseau sign?
carpopedal spasm
what is the most common cause of hypocaclaemia?
hypoparathyroidism
treatment of acute hypocalcaemia?
IV calcium gluconate. 10ml 10% over 10 minutes
long-term management of hypocalcaemia?
calcium supplement, Vit D
calcium release from cells is dependant on what other metal element?
magnesium
if magnesium is deficient what effect does this have on calcium?
intracellular calcium is high
what are the causes of hypmagnasaemia?
alcohol, drugs, GI illness, pancreatitis, malabsorption
what is pseudohypoparathyroidism caused by?
genetic defect, GNAS 1
what effect does pseudohypoparathyroidism have on calcium and PTH?
low calcium, high PTH
whats the difference between pseudohypoparathyroidism and pseudo-pseudohypoparathyroidism?
normal calcium
what drug group can cause rickets?
anticonvulsants
what does osteomalacia look on an X-ray/gait exam?
waddling gait, pseudo fractures on X-ray
what are loosers zones?
patches of bone that are less calcified than normal
what are patients with chronic renal disease at risk of?
Vit D deficiency, secondary hyperparathyroidism
