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my Endocrinology > Calcium homeostasis > Flashcards

Calcium homeostasis Flashcards

1
Q

What hormone is secreted by the parathyroid glands and involved in Calcium homeostasis?

A

PTH, parathyroid hormone

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2
Q

What are the symptoms of Hypercalcaemia?

A

Stones, groans, bones, psychic moans

  • thirst
  • dehydration
  • confusion
  • polyuria
  • fractures
  • depression
  • hypertension
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3
Q

Why do granulomatous diseases cause hypercalcaemia?

A

TB and sarcoidosis

-produce vitamin D

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4
Q

Name 4 causes of Hyoercalcaemia:

A
  1. Primary Hyperparathyroidism
  2. Malignancy
  3. Granulomatous disease
  4. Familial Hypocalciuric Hypercalcaemia
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5
Q

What drugs can cause hypercalcaemia?

A

Thiazide diuretics

Vitamin D

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6
Q

How is hypercalcaemia treated?

A
  • rehydrate with IV fluids
  • flush Ca out with loop diuretics (NOT thiazide)
  • bisphosphonates
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7
Q

Why is Calcium raised in Familial Hypocalciuric Hypercalcaemia? How is diagnosis confirmed?

A
  • Calcium detection level by Calcium Sensing Receptors in parathyroid glands is raised
  • negative feedback occurs at higher plasma calcium

If PTH and serum Ca are raised, confirm FHH by checking if urine calcium
-if low, it’s FHH

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8
Q

What are the symptoms/signs of Hypocalcaemia?

A
  • loss of sensation in peripheries
  • muscle cramps and weakness
  • fits
  • QT prolongation on ECG
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9
Q

Name 3 causes of Hypocalcaemia.

A
  1. Hypoparathyroidism
  2. Vitamin D deficiency
  3. Chronic renal failure
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10
Q

What is the treatment of acute Hypocalcaemia?

A

Emergency!

-IV calcium gluconate

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11
Q

What are the causes of Hypoparathyroidism?

A
  • congenital (DiGeorge syndrome - congenital absence)
  • Surgical/radiotherapeutic /autoimmune desctruction
  • Hypomangesaemia
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12
Q

Why is PTH release inhibited in Hypomagnasaemia?

A
  1. Calcium release from cells is Mg-dependent
  2. Intracellular calcium is high
  3. PTH release is inhibited by high Ca
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13
Q

What is the cause of Pseudohypoparathyroidism?

A

PTH resistance

-does not induce desired resorption/absorption of Ca

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14
Q

Describe the biochemistry of Primary Hyperparathyroidism?

A

Calcium: high
PTH: high
ALP: normal
Phosphate: low

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15
Q

Describe the biochemistry of bone malignancy.

A

Calcium: high
PTH: low (suppressed)
ALP: v. high
Phosphate: normal

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16
Q

Describe the biochemistry of Familial Hypocalciuric Hypercalcaemia.

A 
Calcium: high (mild)
PTH:  normal/mild elevation
ALP:  normal
Phosphate: normal/mild elevation
Urine Calcium:  low
17
Q

Describe the biochemistry of Hypoparathyroidism.

A

Calcium: low
PTH: low
ALP: normal
Phosphate: normal/mild elevation

18
Q

Describe the biochemistry of osteomalacia.

A

Calcium: low
PTH: high
ALP: v. high
Phosphate: low

19
Q

Describe the biochemistry of Paget’s disease?

A

Calcium: normal (slightly high)
PTH: normal
ALP: High
Phosphate: normal

my Endocrinology (23 decks)

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