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Endocrinology > Calcium in Clinical Practice > Flashcards

Calcium in Clinical Practice Flashcards

1
Q

What can cause hypercalcaemia?

A 
Hyperparathyroidism
Osteolytic bone metastases
Multiple myeloma
Paget's disease
Thiazide use
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2
Q

What cancers commonly metastasise to bone and cause lytic lesions?

A

Breast
Lung
Renal
Thyroid

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3
Q

What is primary hyperparathyroidism?

A

One of the 4 parathyroid glands develops an adenoma and secretes excessive PTH

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4
Q

What is secondary hyperparathyroidism?

A

Disease outside of the parathyroid glands causes them to become hyperplastic

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5
Q

What can cause secondary hyperparathyroidism?

A

Vitamin D deficiency

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6
Q

What is a common symptom of secondary hyperparathyroidism?

A

Bone pain

Due to osteomalacia as raised PTH activates osteoclasts

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7
Q

What happens to biochemistry in primary hyperparathyroidism?

A

Serum calcium - rises
Serum phosphate - falls/same
Serum alkaline phosphatase - same
Serum PTH - rises

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8
Q

What happens to biochemistry in secondary hyperparathyroidism?

A

Serum calcium - falls/same
Serum phosphate - rises/same
Serum alkaline phosphatase - rises
Serum PTH - rises

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9
Q

What happens to biochemistry in malignant hyperparathyroidism?

A

Serum calcium - rises
Serum phosphate - same
Serum alkaline phosphatase - rises
Serum PTH - same/falls

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10
Q

What are symptoms of primary hyperparathyroidism?

A

Moans - tiredness + depression
Groans - constipation + pancreatitis
Stones - kidney stones
Bones - bone + muscle aches

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11
Q

What effect does hypercalcaemia have on nerves?

A

Suppression of neuronal activity

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12
Q

What effect does hypocalcaemia have in nerves?

A

Leads to excitable nerves

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13
Q

What the blood level for hypercalcaemia?

A

Serum calcium >3.0mmol/l

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14
Q

What are symptoms of hypercalcaemia?

A 
Polyuria
Lethargy
Weakness
Condusion 
Coma
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15
Q

What is the main treatment for hypercalcaemia?

A

Rehydration

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16
Q

What are symptoms of hypocalcaemia?

A

Tingling lips + fingers
Tetany
Carpopedal spasm

17
Q

What is the difference between osteoporosis and osteomalacia?

A

Osteoporosis = normal ratio of mineral to matrix

  • structurally degraded
  • fully mineralised

Osteomalacia = decreased ratio of mineral to matrix

  • normal structure
  • under mineralised
18
Q

What causes osteomalacia?

A

Vitamin D deficieny

  • dietary
  • environmental
  • chronic renal disease
19
Q

What is osteomalacia in children called?

A

Rickets

20
Q

What are risk factors for osteoporosis?

A 
Postmenopausal women 
Low BMI
Long-term steroid use
Heavy alcohol 
Smoking 
Prolonged inactivity

Endocrinology (13 decks)

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