Calcium Pales

Question 1

tx osteoporosis

Answer 1

PTH - weird

Question 2

stimulation of PTH release

Answer 2

low Ca

high Mg

Question 3

obese patient, sits around watching TV, tums, mylanta

Answer 3

milk alkali

-cause of hyperCa

Question 4

most common hyperCa cause

Answer 4

primary hyperPTH

parathyroid adenoma
-seen with MEN1

mostly - asymptomatic**

Question 5

tertiary hyperPTH

Answer 5

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

Question 6

familial benign hypocalciuric hypercalcemia

Answer 6

low calcium in urine - high in blood

LOF mutation in CaSR - calcium sensor in parathyroid

high PTH, despite high Ca

Question 7

stones, bones, groans, moans, overtones

Answer 7

hyperCa

Question 8

skin necrosis with hyperCa

Answer 8

calciphylaxis

deposits in small arterioles

Question 9

calcium deposits in cornea

Answer 9

band keratopathy

Question 10

osteotitis fibrosis cystica

Answer 10

with hyperPTH

Question 11

high PTH and high 24 hour urine Ca

Answer 11

primary hyper PTH

Question 12

hyperCa, high PTH and low 24 hour urine Ca

Answer 12

benign familial hypocalciuric hypercalcemia

Question 13

low PTH with hyperCa

Answer 13

cancer, granulomatous, drug, thyroid

check PTH-rP and vit D metabolites

Question 14

tx of hyperCa

Answer 14

IV fluid
furosemide - loop
bisphosphonate

Question 15

di george

Answer 15

CATCH-22

has autoimmune hypoPTH

Question 16

acquired hypoPTH

Answer 16

post thyroidectomy
autoimmune
heavy metal - copper, Fe
Mg deficiency - alcoholism
infection
tumor
granulomatous

Question 17

pseudohypoPTH

Answer 17

end organ resistance to PTH

results in hypercalciuria

Question 18

soft spot baby head, bony necklace, curved bones, lumpy joints, bowed legs

Answer 18

rickets

vit D deficiency

Question 19

hypoMg

Answer 19

cofactor for PTH release

Question 20

acute hypoCa

Answer 20

cramp, tetany, irritability, carpopedial spasm, convulsions, tingling

Question 21

chronic hypoCa

Answer 21

lethargy, personality changes, anxiety, bulrry vision, parkinson, mental retardation

Question 22

troussea sign

Answer 22

hypoCa

-BP cuff causes spasm

Question 23

chovstek sign

Answer 23

tap facial muscle - contract

sign of hypoCa

Question 24

work up for hypoCa

Answer 24

look at albumin**

Question 25

albumin and Ca

Answer 25

every 1 down for albumin

-add 0.8 to Ca

Question 26

high PTH, high Cr, high P

Answer 26

secondary hyperPTH of renal failure

Question 27

high PTH, normal Cr, normal P

Answer 27

measure VIt Ds

Question 28

high PTH, normal Cr, high P

Answer 28

consider PTH resistance

Question 29

osteotis deformans

Answer 29

pagets disease

accelerated bone turnover

Question 30

pagets cardiac

Answer 30

high output failure

-high vascular to bones

Question 31

follow pagets disease

Answer 31

alk phosphate

Question 32

dexa scan scores

Answer 32

normal > -1
osteopenia -1 - 2-5
osteoporosis < -2.5

Question 33

erosive esophagitis and jaw osteonecrosis

Answer 33

with bisphosphonate

Question 34

denosumab

Answer 34

binds RANKL

Question 35

tertiary hyperPTH

Answer 35

need high Cr - renal failure

Question 36

sestamibi scan

Answer 36

to localized hot nodule in hyperPTH