Calcium - Metabolism and Disorders Flashcards
hypercalcaemia symptoms?
bones
stones
abdominal groans
psychic moans
acute hypercalcaemia symptoms?
thirst
dehydration
confusion
polyuria
chronic hypercalaemia symptoms?
myopathy fractures osteopaenia depression hypetension pancreatitis DU renal calculi
name the test performed for hypercalaemia
PTH test
where is the problem if PTH is HIGH in hypercalaemia?
bone problem
where is the problem if PTH is LOW in hypercalaemia?
parathyroid problem
2 main types of hypercalcaemia?
primary hyperparathyroidism
malignancy
raised serum calcium
raised serum PTH
increased urine calcium
diagnosis?
primary hyperparathyroidism
raised calcium and alkaline phosphatase
diagnosis?
hypercalcaemia of malignancy
acute hypercalcaemia treatment?
fluids
loop diuretics
biphosphonates
treatment of sarcoidosis?
prednisolone
name the scan used to view the parathyroids
sestamibi scan
primary hyperparathyroidism treatment?
surgery
cinacalcet - calcium mimetic
end organ damage
very high calcium
under 50 years old
eGFR < 60
the above are all indications for what?
parathyroidectomy
name the 3 types of hyperparathyroidism
primary
secondary
tertiary
primary, secondary or tertiary hyperparathyroidism:
high calcium and high PTH
primary overactivity of parathyroid gland i.e adenoma
primary
primary, secondary or tertiary hyperparathyroidism:
high calcium and high PTH
parathyroid becomes autonomous after many years of overactivity e.g renal failure
tertiary
primary, secondary or tertiary hyperparathyroidism:
low calcium and high PTH
physiological response to low calcium or vit D
secondary
what genetic syndrome results in a developed parathyroid adenoma with hypercalcaemia at a young age?
MEN1/2
80 year old man presents to ARU with 1 stone weight loss, cough, back pain
cCa2+ level= 3.4 (HIGH)
Phosp= 1.4 (NORMAL)
Alk Phos= 272 (HIGH)
CXR - LLL collapse
diagnosis?
malignant hypercalcaemia
33 year old woman presents to bone clinic with incidental hypercalcaemia
high cCa2+ (hypecalcaemia)
low Ca in urine
diagnosis?
familial hypocalciuric hypercalcaemia
hypocalciuric hypercalcaemia is autosomal __________ and requires _______ screening
hypocalciuric hypercalcaemia is autosomal DOMINANT and requires GENETIC screening
Paraesthesia - fingers, toes, perioral Muscle cramps, tetany Muscle weakness Fatigue Bronchospasm or laryngospasm Fits Chovsteks sign (tapping over facial nerve) Trousseau sign (carpopedal spasm) ECG: QT prolongation
the above are all signs and symptoms of what?
hypocalcaemia
acute hypocalcaemia treatment?
IV calcium gluconate
Infusion - infusate
name the syndrome associated with hypoparathyroidism
DiGeorge syndrome
hypoparathyroidism is also associated with hypo_____________
hypoparathyroidism is also associated with hypoMAGNESAEMIA
long term management of hypoparathyroidism
calcium supplement
vitamin D tablet
what causes hypomagnasaemia?
alcohol thiazides PPI Gi illness pancreatitis malabsorption
low calcium but PTH high bone abnormalities obesity learning disability brachdactyly
diagnosis?
Pseudohypoparathyoidism
Albright’s Herditary Osteodystrophy but no alteration in PTH action and thus normal calcium
diagnosis?
pseudo-pseudohypoparathyroidism
rickets and osteomalacia is a vitamin _ deficiency
rickets and osteomalacia is a vitamin D deficiency
low calcium
muscle wasting
dental defects
bone tenderness, fractures, rib deformities
diagnosis?
osteomalacia - waddling gait
chronic renal disease is due to vitamin _ deficiency and results in secondary ______parathyroidism
chronic renal disease is due to vitamin D deficiency and results in secondary HYPERparathyroidism
chronic treatment for vitamin D deficiency?
Vitamin D3 tablets - calcitriol or alfacalcidol
low phosphate and high vitamin D
X-linked hypophosphataemia
diagnosis?
vitamin D resistant rickets
treat with phosphate and Vit D supplements
