Calcium Pales Flashcards
tx osteoporosis
PTH - weird
stimulation of PTH release
low Ca
high Mg
obese patient, sits around watching TV, tums, mylanta
milk alkali
-cause of hyperCa
most common hyperCa cause
primary hyperPTH
parathyroid adenoma
-seen with MEN1
mostly - asymptomatic**
tertiary hyperPTH
reduced Vit D activation with renal disease
> leading to elevated PTH
> lots of stimulation causes glands to become hyperplastic and become unregulated by vit D
familial benign hypocalciuric hypercalcemia
low calcium in urine - high in blood
LOF mutation in CaSR - calcium sensor in parathyroid
high PTH, despite high Ca
stones, bones, groans, moans, overtones
hyperCa
skin necrosis with hyperCa
calciphylaxis
deposits in small arterioles
calcium deposits in cornea
band keratopathy
osteotitis fibrosis cystica
with hyperPTH
high PTH and high 24 hour urine Ca
primary hyper PTH
hyperCa, high PTH and low 24 hour urine Ca
benign familial hypocalciuric hypercalcemia
low PTH with hyperCa
cancer, granulomatous, drug, thyroid
check PTH-rP and vit D metabolites
tx of hyperCa
IV fluid
furosemide - loop
bisphosphonate
di george
CATCH-22
has autoimmune hypoPTH
acquired hypoPTH
post thyroidectomy autoimmune heavy metal - copper, Fe Mg deficiency - alcoholism infection tumor granulomatous
pseudohypoPTH
end organ resistance to PTH
results in hypercalciuria
soft spot baby head, bony necklace, curved bones, lumpy joints, bowed legs
rickets
vit D deficiency
hypoMg
cofactor for PTH release
acute hypoCa
cramp, tetany, irritability, carpopedial spasm, convulsions, tingling
chronic hypoCa
lethargy, personality changes, anxiety, bulrry vision, parkinson, mental retardation
troussea sign
hypoCa
-BP cuff causes spasm
chovstek sign
tap facial muscle - contract
sign of hypoCa
work up for hypoCa
look at albumin**
albumin and Ca
every 1 down for albumin
-add 0.8 to Ca
high PTH, high Cr, high P
secondary hyperPTH of renal failure
high PTH, normal Cr, normal P
measure VIt Ds
high PTH, normal Cr, high P
consider PTH resistance
osteotis deformans
pagets disease
accelerated bone turnover
pagets cardiac
high output failure
-high vascular to bones
follow pagets disease
alk phosphate
dexa scan scores
normal > -1
osteopenia -1 - 2-5
osteoporosis < -2.5
erosive esophagitis and jaw osteonecrosis
with bisphosphonate
denosumab
binds RANKL
tertiary hyperPTH
need high Cr - renal failure
sestamibi scan
to localized hot nodule in hyperPTH
