calcium metabolism and disorders Flashcards
what are the classic symptoms of hypercalcemia?
- bones (bony pain)
- stones (kidney stones)
- abdominal groans (abdominal pain)
- psychic moans
what are some acute symptoms of hypercalcemia?
- thirst
- dehydration
- confusion
- polyuria
classic ones:
- bones (bony pain)
- stones (kidney stones)
- abdominal groans (abdominal pain)
- psychic moans
what are some chronic symptoms of hypercalcemia?
- myopathy
- fractures
- osteopenia
- depression
- hypertension
- pancreatitis
- DU
- renal calculi
Classic:
- bones (bony pain)
- stones (kidney stones)
- abdominal groans (abdominal pain)
- psychic moans
what are most common causes of hypercalcemia?
- primary hyperparathyroidism
- malignancy
what are some rarer causes of hypercalcaemia?
- drugs (vit D, thiazides)
- Granulomatous diseases (sarcoidosis, TB)
- familial hypocalciuric hypercalcaemia
- high turnover (bedridden, thyrotoxic, Pagets)
- tertiary hyperparathyroidism
what is the treatment for acute hypercalcaemia?
- fluids to rehydrate
- consider loop diuretics once rehydrated (avoid thiazides)
- biphosphonates
- steroids sometimes used
if malignant chemo
what is primary hyperparathyroidism?
- primary overactivity of the parathyroid gland i.e. adenoma
- it means there is a problem with the parathyroid gland itself
what occurs to the calcium and PTH levels in primary hyperparathyroidism?
both calcium and PTH are raised
what is secondary hyperparathyroidism?
-this is when the thyroid produces too much PTH in response to hypocalcaemia
what are the calcium levels and PTH levels like in secondary hyperparathyroidism?
- calcium levels are low
- PTH levels raised
what is tertiary hyperparathyroidism?
- the parathyroid becomes autonomous after many years of activity e.g. renal failure
- it just stops responding to the negative feedback
what are the levels of calcium and PTH like in hyperparathyroidism?
-both calcium and PTH are raised
what genetic syndrome will always develop a parathyroid adenoma with hypercalcaemia at a very young age?
-MEN1 and MEN2
what is another genetic condition apart from MEN1/2 that causes an adenoma causing primary hyperparathyroidism?
-familial isolated hyperparathyroidism
what are some symptoms of hypocalcaemia?
- paraesthesia (tingling) around fingers, toes, lips
- muscle cramps
- muscle weakness
- fatigue
- bronchospasm or laryngospasm
- fits
- Chovsteks sign (firing of fascial nerve when you tap over it)
- Trousseau sign (carpopedal spasm)
- ECG has prolonged QT
