calcium metabolism and disorders Flashcards
1
Q
symptoms of hypercalcaemia
A
- boney pain
- kidney stones
- abdominal groans
- psychic moans
2
Q
acute symptoms of hypercalcaemia
A
- thirst
- dehydration
- confusion
- polyuria
3
Q
chronic symptoms of hypercalcaemia
A
- myopathy
- fractures
- osteopaenia
- depression
- hypertension
- pancreatitis
- DU
- renal calculi
4
Q
causes of hypercalcaemia
A
- primary hyperparathyroidism
- malignancy
5
Q
is PTH is low then what does this mean the cause is
A
bone pathology
6
Q
if PTH is high/normal what does this mean the cause is
A
- primary/tertiary hyperparathyroidism (if increased UrCa excretion)
- FHH (if decreased UrCa excretion)
7
Q
if theres increased ALP what does this mean cause is
A
- metastases
- sarcoidosis
- thyrotoxicosis
8
Q
if decreased ALP what does this mean the cause is
A
- myeloma
- Vit D toxicity
- milk-alkali
9
Q
what confirms a diagnosis of primary hyperparathyroidism
A
- raised serum calcium
- raised serum PTH
- increase urine calcium excretion
10
Q
what mechanisms of malignancy cause hypercalcaemia
A
- metastatic bone destruction
- PTHrp from solid tumours
- osteoclast activating factors
11
Q
diagnosis of hypercalaemia by malignancy
A
- raised calcium and alkaline phosphotase
- X-ray, CT, MRI, PET
- isotope bone scan
12
Q
indications for parathyroidectomy
A
- bone disease
- gastric ulcers
- renal stones
- osteoporosis
13
Q
what happens in familial hypocalciuric hypercalaemia
A
the calcium sensing receptor becomes insensitive to calcium so effect on PTH is much less
- less calcium in urine
- more calcium altogether
14
Q
symptoms and signs of hypocalcaemia
A
- paraesthesia
- muscle cramps
- muscle weakness
- fatigue
- bronchospasm or laryngospasm
- fits
- chovsteks sign
- trousseau sign
- QT prolongation on ECG
15
Q
treatment of acute hypocalcaemia
A
EMERGENCY
- IV calcium gluconate
- infusion
