Calcium disorders Flashcards
what things help regulate the calcium homeostasis in the body?
diet, gut absorption, PTH, Vit D,
what can PTH disorders lead toq
hyper/hypoparathyroidism, malignant hypercalcaemia
What affect does Vit D have on the body
diet absorption, renal, liver disease, UVB exposure, drugs
how is calcium homeostasis controlled?
through negative feedback
what is vitamin D made from initially
dehydro cholesterol
what are the acute symptoms of hypercalcaemia
thirst, dehydration, confusion, polyuria
what are some chronic symptoms of hypercalcaemia
myopathy, osteopaenia, fractures, depression, hypertension, abdo pain
what would be the main test you would do for hypercalacemia
PTH
if both the albumin and urea are raised, what is the result?
dehydration
if the albumin is normal/ low and PTH is suppressed, phosphate high, what would be the diagnosis
bone pathology
if the PTH was normal/high, phosphate low/ normal, increased urine Ca, the diagnosis would be
Primary/ tertiary hyperparathyroidism
IF the urine Ca is low, what would the diagnosis be
FHH
what are the main causes of hypercalcaemia
primary hyperparathyroidism, malignancy, drugs, granulomatous disease, tertiary hyperparathyroidism
how would you diagnose hyperparathyroidism
rasised serum Ca, rasied PTH, increased urine calcium excretion
how would you diagnose a hypercalcaemia malignancy
raised calcium, ALP, XRAY, CT, MRI, Isotope bone scan
how would you treat hypercalcaemia acutely
rehydrate with fluids, loop diuretics Bisphosphonates lowers Ca over 2-3d
what is the management of primary hyperparathyroidism
surgery or nothing
when would you have surgery
end organ damage- osteoporosis, renal stones, gastric ulcers, bone disease, v v v high calcium,
what s significant about secondary hyperparathyroidism
Ca is low, but PTH is raised, wherasfor 1 and 3 hyperparathyroidism, both Ca and PTH is raised.
what is hypocalciuric hypercalcaemia
low calcium in the urine
how can one get hypocalciureic hypercalcaemia
familial and benign/ assymptomatic
what are some symptoms of hypocalcaemia
paraesthesia, muscle cramps, muscle weakness, fatigue, fits, bronchospasm, chvsteks sign and trousseau sign
what are some causes of hypocalcaemia
hypoparathyroidism, vit D deficiency, chronic renal failure
what medication should be given in an emergency hypocalcaemia
IV calcium gluconate- 10ml, 10% 10 mins
Why would you get hypoparathyroidism
congenital, destruction, autoimmune, hypomagnesaemia, idiopathic
what is the long term treatment for hypocalcaemia
calcium supplement, Vit D tablets
in hypomagnesaemia, is calcium high or low
high
Is PTH release inhibited or stimulated
inhibited
what are some causes of hypomagnesaemia
alcohol, drugs, GI, pancreatitis, malabsorption
what is pseudohypoparathyroidism
low calcium, PTH resistance, PTH levels high, genetic defect,
what are some signs of pseudohypoparathyroidism
obese, learning difficulty, bone abnormalities, branchdactyly
what is different about pseudo-pseudohypoparathyroidism
instead of the calcium being low, the calcium is normal in this case
what is the cause of rickets and osteomalacia
vitamin D deficiency
what conditions can predispose you to rickets/ osteomalacia
chronic renal disease, GI malabsorption, lack of sunlight, drugs
what is osteomalacia clinically
low calcium, muscle wasting- prox myopathy, dental defects, bone fractures/ tenderness, limb deformity
what type of hyperparathyroidism can chronic renal disease cause
secondary
what is the chronic treatment for osteomalacaia
vit D tablets
