Calcium & Its Conditions Flashcards
What are the two most common causes of hypercalcemia
primary hyperparathyroidism and malignancy-associated hypercalcemia (MAHC)
What are the main causes of hyperparathyroidism
adenoma hyperplasia and tertiary hyperparathyroidism of renal failure
Which granulomatous disorders can cause hypercalcemia
tuberculosis and sarcoidosis
Which endocrine disorders can lead to hypercalcemia
hyperthyroidism and adrenal insufficiency
Which medications can contribute to hypercalcemia
vitamin D preparations thiazides and vitamin A
What are two miscellaneous causes of hypercalcemia
aluminum toxicity and acute renal failure
What symptoms can mild hypercalcemia cause
fatigue depressed affect and asthenia
How does hypercalcemia cause dehydration
increased calcium leads to hypercalciuria and water loss
What cognitive effects can severe hypercalcemia cause
impaired concentration memory loss stupor and coma
What cardiovascular effects can hypercalcemia cause
bradycardia QT shortening AV block and arrhythmias
What is the first test for diagnosing hypercalcemia
serum intact PTH level
If hypercalcemia is present and PTH is elevated what is the likely diagnosis
primary hyperparathyroidism
If PTH is low and malignancy is present what is suspected
malignancy-associated hypercalcemia (MAHC)
What is the first step in treating hypercalcemia
rehydration with isotonic saline
After rehydration what treatment can help excrete calcium
loop diuretics
Which drug acts fastest to reduce calcium levels
calcitonin
What is the standard treatment for malignancy-associated hypercalcemia
bisphosphonates
How is hypocalcemia defined
abnormally low serum ionized calcium
What are three main causes of hypocalcemia
low PTH PTH resistance and abnormal calcium metabolism
What are common causes of reduced or absent PTH secretion
surgery infiltrative diseases and radiation
Which conditions cause PTH resistance
pseudohypoparathyroidism and hypomagnesemia
What can cause hypocalcemia despite normal or high PTH levels
hyperphosphatemia vitamin D malabsorption and hungry bone syndrome
What is the hallmark sign of hypocalcemia
tetany
What is the earliest symptom of hypocalcemia
perioral and fingertip paresthesias
What is Trousseau’s sign
carpal spasm when inflating a BP cuff above systolic pressure
What is Chvostek’s sign
facial muscle twitching when tapping the facial nerve
What is the first step in diagnosing hypocalcemia
confirming low ionized calcium
What should be measured if hypocalcemia is confirmed
serum PTH level
What does low PTH in hypocalcemia indicate
hypoparathyroidism
What is the emergency treatment for severe hypocalcemia
IV calcium gluconate
What should be corrected if hypomagnesemia is present
magnesium levels
What is the goal calcium range for long-term hypocalcemia management
8.5 to 9.2 mg/dL
What is the preferred long-term treatment for hypocalcemia
calcium supplements with vitamin D metabolite
What are the two most common causes of hypercalcemia
primary hyperparathyroidism and malignancy-associated hypercalcemia (MAHC)
What are the main causes of hyperparathyroidism
adenoma hyperplasia and tertiary hyperparathyroidism of renal failure
Which granulomatous disorders can cause hypercalcemia
tuberculosis and sarcoidosis
Which endocrine disorders can lead to hypercalcemia
hyperthyroidism and adrenal insufficiency
Which medications can contribute to hypercalcemia
vitamin D preparations thiazides and vitamin A
What are two miscellaneous causes of hypercalcemia
aluminum toxicity and acute renal failure
What symptoms can mild hypercalcemia cause
fatigue depressed affect and asthenia
How does hypercalcemia cause dehydration
increased calcium leads to hypercalciuria and water loss
What cognitive effects can severe hypercalcemia cause
impaired concentration memory loss stupor and coma
What cardiovascular effects can hypercalcemia cause
bradycardia QT shortening AV block and arrhythmias
What is the first test for diagnosing hypercalcemia
serum intact PTH level
If hypercalcemia is present and PTH is elevated what is the likely diagnosis
primary hyperparathyroidism
If PTH is low and malignancy is present what is suspected
malignancy-associated hypercalcemia (MAHC)
What is the first step in treating hypercalcemia
rehydration with isotonic saline
After rehydration what treatment can help excrete calcium
loop diuretics
Which drug acts fastest to reduce calcium levels
calcitonin
What is the standard treatment for malignancy-associated hypercalcemia
bisphosphonates
How is hypocalcemia defined
abnormally low serum ionized calcium
What are three main causes of hypocalcemia
low PTH PTH resistance and abnormal calcium metabolism
What are common causes of reduced or absent PTH secretion
surgery infiltrative diseases and radiation
Which conditions cause PTH resistance
pseudohypoparathyroidism and hypomagnesemia
What can cause hypocalcemia despite normal or high PTH levels
hyperphosphatemia vitamin D malabsorption and hungry bone syndrome
What is the hallmark sign of hypocalcemia
tetany
What is the earliest symptom of hypocalcemia
perioral and fingertip paresthesias
What is Trousseau’s sign
carpal spasm when inflating a BP cuff above systolic pressure
What is Chvostek’s sign
facial muscle twitching when tapping the facial nerve
What is the first step in diagnosing hypocalcemia
confirming low ionized calcium
What should be measured if hypocalcemia is confirmed
serum PTH level
What does low PTH in hypocalcemia indicate
hypoparathyroidism
What is the emergency treatment for severe hypocalcemia
IV calcium gluconate
What should be corrected if hypomagnesemia is present
magnesium levels
What is the goal calcium range for long-term hypocalcemia management
8.5 to 9.2 mg/dL
What is the preferred long-term treatment for hypocalcemia
calcium supplements with vitamin D metabolite
