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1. Endocrine > Calcium disorders > Flashcards

Calcium disorders Flashcards

1
Q

How does the body turn sunlight into vitamin D?

A

turns it into cholecaliferol
cholecaliferol is turned into 25-hydroxy-cholecaliferol in the liver
25-hydroxy-cholecaliferol is turned into 1,25-hydroxy-cholecaliferol in the kidneys which is vitamin D3

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2
Q

How does the parathyroid gland increase Ca?

A

released PTH which increases Ca reabsorption from the gut, kidneys and mobilisation of Ca from bones

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3
Q

How does high PTH cause the formation of bone?

A

it will inhibit sclerosin (which inhibits the signals to osteoblasts)

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4
Q

What is the rhyme for Hypercalcaemia?

A

bones, stones, abdo groans and psychic moans

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5
Q

What are the acute symptoms of Hypercalcaemia?

A

thirst
dehydration
confusion
polydipsia

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6
Q

What are the chronic symptoms of Hypercalcaemia?

A 
myopathy
fractures
osteopenia
depression
hypertension
pranreatitis
renal calculi
Duodenal ulcer
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7
Q

How is hypercalcaemia diagnosed?

A

increased PTH levels
increased serum calcium
increased urine calcium excretion

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8
Q

What can cause hypercalcaemia?

A 
primary hyperparayhroidism 
malignancy
drugs - vit D, thiazides
familial hypocalciuric hypercalcaemia
granulomatosis - sarcoid or TB
bedridden
pagets 
thyrotoxic
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9
Q

When does hypercalceamia occur due to malignancy?

A

metastatic bone destruction
PTHrp from solid tumours - squamous cell
osteoclast activating tumours

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10
Q

What is the treatment for acute hypercalcaemia?

A

fluid rehydrate with 0.9% saline in 2hrs

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11
Q

What is the treatment for rehydrated acute or chronic hypercalceamia?

A

loop diuretics
biphosphonates
if sarcoidosis -> prednisolone 40-60mg

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12
Q

What is hyperparathyroidism due to?

A

high calcium and PTH

often due to an adenoma

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13
Q

What is the diagnosis of hyperparathyroidism?

A

Sestambibi scan - measures the uptake to localise the lesions

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14
Q

What is the treatment of hyperparathyroidism?

A

parathyroidectomy is the only curative
cincalcet: a drug that mimics calcium on the PTH receptor to reduce PTH, given to tertiary hyper and in parathyroid carcinomas

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15
Q

What is primary hyperparathyroidism?

A

primary overactivity of the parathyroid gland, high Ca and PTH

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16
Q

What is secondary hyperparathyroidism?

A

physiological response to low Ca or Vit D, but still high PTH

17
Q

What is tertiary hyperparathyroidism?

A

parathyroid becomes unresponsive to signals after many years of inactivity

18
Q

What is hypocalciuric hypercalceamia?

A

familail autosomal dominant deactivating mutation in the Ca receptor

19
Q

How does hypocalciuric hypercalceamia presents?

A

mild hyperglycaemia
decreased Ca urine excretion
increased PTH

20
Q

What are the symptoms of Hypocalceamia?

A 
peripheral parasthesia 
muscle cramps 
muscle weakness
fatigue
bronchospasm
fits
chovesteks sign - facial spasm
trousseau sign - carpopedal sign
QT PROLONGATION ON ECGs
21
Q

What is the acute treatment of hypocalcaemia?

A

IV calcium gluconate 10ml, 10% over 10mins

22
Q

What is the chronic treatment of hypocalcaemia?

A

calcium supplement >1-2g per day
Vit D tablets
1 alphacalcidol and cholecalciferol injection

23
Q

What is cellular calcium release dependant on?

A

magnesium

24
Q

What are the biochemical signs of hypomangansaemia?

A

high Ca, low Mg, low PTH

25
Q

What are the causes of hypomangansaemia?

A 
alcohol
drugs - thiazides and PPIs
GI illness
Pancreatitis
malabsorption
26
Q

What is pseudohypoparathyroidism?

A

genetic defect causing a dysfunction of the G protein gene - GNAS1 which is coupled to the PTH receptor so causes PTH resistance

27
Q

What is the biochemical signs of pseudohypoparathyroidism?

A

low Ca
high PTH
normal Vit D

28
Q

What are the symptoms of pseudohypoparathyroidism?

A 
bone abnormalities - McCune Albright
obesity
subcutaneous calcification
learning difficulties
brachdactyly - shortening of 4th metatarsal 
short stature
29
Q

What is pseudopseudohypoparathyroidism?

A

same as pseudohypoparathyroidism but no PTH alteration so normal Ca

1. Endocrine (32 decks)

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