Calcium Disorders

Question 1

causes of hypercalcaemia

Answer 1

hyperparathyroidism
malignant (PTHrp from tumours)
thiazides
granulomatous disease (sarcoid, TB)
FHH 
high turnover (Paget's)

Question 2

presentation of hypercalcaemia

Answer 2

bone, stones, abdominal groans and psychic moans

can present as nephrogenic DI

Question 3

nephrogenic DI presentation that mimics hypercalcaemia

Answer 3

thirst
dehydration
polyuria
confusion

Question 4

diagnosis of hypercalcaemia

Answer 4

bloods
urine

show high calcium and ALP with low PTH

Question 5

management of hypercalcaemia

Answer 5

acute= saline 4-6L in 24 hours

consider loop diuretics, bisphosphonates, steroids

Question 6

what is FHH?

Answer 6

familial hypocalciuric hypercalcaemia

Question 7

what causes FHH?

Answer 7

AD mutation in calcium sensing receptor causing excess PTH and high calcium as a result

Question 8

presentation of hypocalcaemia

Answer 8

tetany
fatigue
bronchospasm

Question 9

diagnosis of hypocalcaemia

Answer 9

Chvostek sign
Trousseau sign
QT prolonged on ECG

Question 10

management of hypocalcaemia

Answer 10

acute= IV calcium gluconate

Question 11

what inhibits calcium release?

Answer 11

magnesium

Question 12

what happens in hypomagnesemia?

Answer 12

when Mg is low, calcium is high and PTH is inhibited

Question 13

causes of hypomagnesemia

Answer 13

alcohol
thiazides
PPIs
malabsorption
pancreatitis

Question 14

management of hypomagnesemia

Answer 14

calcium and magnesium replacement

Question 15

what is Ricket’s/osteomalacia?

Answer 15

vitamin D deficiency

Question 16

causes of Ricket’s/ osteomalacia

Answer 16

diet
malabsorption
renal failure
lack of sun
drugs (AEDs)

Question 17

presentation of Ricket’s/osteomalacia

Answer 17

proximal myopathy
dental defects
bone tenderness and deformity (Losser’s zones)

Question 18

what causes vitamin D resistant rickets?

Answer 18

X-linked hypophosphatemia

Question 19

diagnosis of ricket’s/osteomalacia?

Answer 19

low calcium