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endocrine > Clinical calcium homeostasis - hypercalcaemia > Flashcards

Clinical calcium homeostasis - hypercalcaemia Flashcards

1
Q

what does a calcium serum level of over 3.5 mmol/l indicate

A

requires urgent correction due to risk of dysrhymia and coma

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2
Q

What are the renal clinical features of hypercalcaemia

A

Polyuria
Polydipsia
nephrolithiasis

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3
Q

What are GI clinical features of hypercalcaemia

A

Anorexia
nausea and vomiting
constipation

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4
Q

What are the MSK clinical features of hypercalcaemia

A

muscle weakness and bone pain

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5
Q

What are the neuro clinical features of hypercalcaemia

A

Decreased concentration
confusion
fatigue
coma

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6
Q

What are the Cardiovascular clinical features of hypercalcaemia

A

Shortened QT interval
bradycardia
hypertension

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7
Q

What does a slow rate of increase of calcium mean in hypercalcaemia

A

It is better tolerated compared to if it was just an acute raise in calcium

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8
Q

What investigations are done for hypercacaemia

A

U&Es
calciuk
phosphate
PTH
ECG

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9
Q

Is primary hyperparathyroidism more common in males or females

A

Females 3:1 males

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10
Q

What is a dexa scan

A

bone scan to measure bone mineral density

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11
Q

What investigation is used to localise parathyroid tumours

A

Parathyroid ultrasound

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12
Q

What re the indications for surgery in primary hyperparathyroidism

A

Symptoms due to hyperparathyroidism
Seum calcium more than 0.25 mmol/l greater than the normal
Osteoporosis
EGFR<60 - CKD or urolithiasis
Age less than 50

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13
Q

What is the treatment of primary hypoparathyroidism

A

Generous fluid intake
Vit D replacement
Cinacalcet
Surgical treatment

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14
Q

What is cinacalcet and how does it work

A

treatment for primary hyperparathyroidism - mimics effect of calcium on the calcium sensing receptor for chief cells which leads to decrease in PTH

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15
Q

What is a post op complication of primary hyperparathyroidism

A

temporary hypocalcaemia

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16
Q

What is familial hypocalciuric hypercalcaemia (FHH)

A

autosomal dominant disorder od calcium sensing receptor
Usually mild hypercalcaemia with no need for treatment

17
Q

What does multiple endocrine neoplasia type 1 and type 2 cause (MEN1)(MEN2)

A

Primary hyperparathyroidism - MEN1 is more common to cause hyperparathyroidism)

18
Q

What is the treatment for hypercalcaemia

A

rehydration
0.9% saline 4-6 litres over 24 hours

IV biphosphonates after rehydration (zolendronic acid 4mg in 15 mins)

19
Q

What are 2nd line treatments for hypercalcaemia

A

glucocorticoids
calcitonic
calcimimetics
parathyroidectomy

20
Q
A

endocrine (30 decks)

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