Calcium Homeostasis

Question 1

Non-PTH mediated hypercalcemia

Answer 1

Malignancy - the most common cause of non-PTH-mediated hypercalcaemia.
Granulomatous conditions - eg, sarcoidosis and tuberculosis.
Endocrine conditions - eg, thyrotoxicosis, phaeochromocytoma and primary adrenal insufficiency.
Drugs - eg, thiazide diuretics, vitamin D and vitamin A supplements.
Familial - eg, familial hypocalciuric hypercalcaemia
High turnover: bedridden, thyrotoxic
Tertiary hyperparathyroidism

Question 2

Diagnosis of Primary Hyperparathyroidism

Answer 2

Raised serum calcium
Raised serum PTH (or inappropriately normal)
Increased urine calcium excretion

Question 3

Signs and symptoms of hypocalcemia

Answer 3

Neuromuscular symptoms include the following:

Numbness and tingling sensations in the perioral area or in the fingers and toes
Muscle cramps, particularly in the back and lower extremities; may progress to carpopedal spasm (ie, tetany)
Wheezing; may develop from bronchospasm
Dysphagia
Voice changes (due to laryngospasm)
Neurologic symptoms of hypocalcemia include the following:

Irritability, impaired intellectual capacity, depression, and personality changes
Fatigue
Seizures (eg, grand mal, petit mal, focal)
Other uncontrolled movements
Chronic hypocalcemia may produce the following dermatologic manifestations:

Coarse hair
Brittle nails
Psoriasis
Dry skin
Chronic pruritus
Poor dentition
Cataracts

Question 4

Are hypoparathyroidism and pseudohypoparathryoidism lifelong disorders?

Answer 4

yes