Calcium Homeostasis and Disorders Flashcards

1
Q

how does PTH increase serium calcium?

A

absorption from gut

resorption from bone

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2
Q

where can you get Vit D from?

A

sun and diet

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3
Q

what does acute hypercalcaemia present with?

A

thirst
dehydration
confusion
poluria

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4
Q

what does chronic hypercalcaemia present like?

A
myoptahy
osteopaenia, fractures
depression
hypertension
abdo pain- pancreatitis uclers, renal stones
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5
Q

moans, groans, bones, stones

depression, constipation, sore bones, renal stones

A

hypercalcaemia

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6
Q

if suspected hypercalcaemia what should you test?

A

PTH

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7
Q

if high Ca and high Alk Phos

A

sarcoidosis
thrytoxicosis
bone metas

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8
Q

if high Ca and low Alk Phos

A

myeloma
Vit D excess
mild alkali syndrome

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9
Q

main 2 causes of hypercalcaemia?

A

primary hyperparathyroidism

maligancy

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10
Q

how do you diagnose primary hyperparathyroidism

A

increased serum calcium
increase serum PTH
increase calcium in urine

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11
Q

how do you treat acute hypercalcaemia?

A

fluids-rehydrate with saline
consider loop diuretics once rehydrated

bisphosphonates
steroids- e.d 40-60mg prednislone for sarcoidosis

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12
Q

management for primary hyperparathyroidism?

A

surgery or nothing

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13
Q

indications for surgery for primary hyperparathyroidism?

A

bone disease
gastric ulcers
renal stones
osteoporosis

eGFR

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14
Q
chovsteks sign (tapping over facial nerve)
Trousseau sign (carpopedal spasm)
A

hypocalcaemia

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15
Q
paraesthesia- fingers and toes
muscle cramps
muscle weakness
fatigue
bronchospasm
fits
QT prolongation
A

hypocalcaemia

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16
Q

causes of hypocalcaemia

A
hypoparathyroidism
vit D deficiency
chronic renal failure
hyperventiliation
pancreatits
17
Q

causes of hypoparathyroidism?

A

congenital
autoimmune
destruction
idiopathic

18
Q

how do you treat acute hypoglycaemia?

A

IV calcium gluconate

19
Q

long term management of hypoglycaemia?

A

calcium supplements

Vit D- tablets or injection

20
Q

what is calcium release from cells dependent on?

A

magnesium

21
Q

what can cause hypomagnasemia?

A
alcohol
thiazides
PPIs
GI illness
pancreatitis
malabsorption
22
Q

genetic defect in GNAS 1 gene
low calcium but high PTH

bony abnormalities
obesity
subcutaneous calcification
learning disability
brachdactyly (4th metacarpal)
A

Pseudohypoparathyroidism

23
Q

what is pseudo-pseudohypoparathyroidism

A

same as pseudohypoparathyroidism but normal calcium level

24
Q

what is rickets and osteomalacia

A

vit D deficiency

25
Q

what can cause Vit D deficiency?

A
lack in diet
lack of sunlight
chronic liver failure
malabsorption-coeliac
drugs-anticonvulsants
26
Q

what is osteopenia?

A

low bone mass

27
Q

how do you assess bone density?

A

DEXA scans

28
Q

what lifestyle management advice should you give for someone with osteoporosis?

A
high intensity strength training
low impact weight bearing exerrcise
avoid excess alcohol
avoid smoking
fall prevention
try to get more calcium from diet
29
Q

what are alendronate and risedronate?

A

bisphosphonates

30
Q

how long should you take bisphosphonates for?

A

5 years cause can cause osteonecrosis of jaw

31
Q

what is Densumab?

A

a monoclonal anitobody for osteoporosis treatment

its an SC injection which can cause cellutlits, eczema and hypocalcaemia

32
Q

drug therapy for osteoporosis?

A
vit D and calcium supplements
bisphosphonates
Denosumab
Teriparatide
HRT
33
Q

what is Teriparatide?

A

recombinant parathyroid hormone which stimulates bone growth . once daily injection

34
Q

what is strontium rabelate?

A

antiresorptive agent