Calcium Homeostasis and Disorders Flashcards
What is the main hormone involved in controlling calcium homeostasis?
Parathyroid hormone (PTH)
What is the effect of PTH on calcium in the skeleton and gut?
Causes increased resorption in the skeleton
Causes increased absorption from the gut
Which vitamin is important in calcium metabolism?
Vitamin D
Give some acute symptoms of hypercalcaemia
Thirst
Dehydration
Confusion
Polyuria
Give some chronic symptoms of hypercalcaemia
Myopathy
Osteopenia
Fractures
Depression
Renal stones
Give some causes of hypercalcaemia
Primary hyperparathyroidism
Malignancy
Familial hypocalciuric hypercalcaemia
Paget’s
What biochemistry results suggests primary hyperparathyroidism?
Raised serum calcium
Raised serum PTH
Increased urine calcium excretion
What acute treatment should be given for hypercalcaemia?
Fluids (rehydration)
Bisphosphonates
Loop diuretics
What are the main indications for parathyroidectomy?
End organ damage
Calcium >2.85
Age <50
eGFR <60
What is secondary hyperparathyroidism?
When low serum calcium raises PTH
What causes familial hypocalciuric hypercalcaemia?
Mutation in CaSR
What are the main markers of familial hypocalciuric hypercalcaemia?
Mild hypercalcaemia
Reduced urine calcium excretion
Give some signs and symptoms of hypocalcaemia
Paraesthesia
Muscle cramps/weakness
Fatigue
Bronchospasm
Chovstek/Trousseau sign
What are some causes of hypocalcaemia?
Hypoparathyroidism
Vit D deficiency
Chronic renal failure
What should be given in acute hypocalcaemia?
IV calcium gluconate
