Endocrine III - calcaemia Flashcards
calcium homeostasis
parathyroid produces parathyroid hormone
PTH acts on the body, release of calcium
calcium feeds back on the PT galnd
what happens if calcium leels decrease
PTH rleased
increased calcium reabsorption in kidney, intestine absorption and bone resoprtion
PTH effect on kidney, bone and intestien
kidney - increase CA reabsopriton decrease phosphate reabsroption intesine increase Ca absorption due to increase vitality D PTH increases Vit D
bone
- increases bone remodelling (bone reabsorption by PTH)
causes of hypocalaemi
vit D deficiency
hypoparathyroidism
radiation
heredirary
consequences of hypocalcaemia
muscle spasm
paraesthesia
seizures
drug interference with calcium
many drugs contain magnesium which can lead to low calcium levels
effect of hypoparathyroisism
decrease Ca renal absorpton
increased phosphate reabsroption
decreased bone resoprton
decrease formation of Vit D
=
decreased serum calcium
management of hypocalcaema
calcium supplements (if Vit D deficiency, cholecalfiferol supplement) if mg difficient, magnesium severe (<1.9mmol/l) - calcium gluconate
1-alphacalciol for hypoparathyroidism
causes of hypercacaemi
malignancy e.g. bone mets, lymphoma
primary hyperparathyroidism
thiazides
family history
symptoms of hypercalcaemia
polyuria, polydipsia
naausea
consipation
consequences of hypercalcamia
pancreatitis
gastic ulcer
renal stones
signs of hypercalcaemia
confusion, hypotonia
dehydration
signs of malignancy
irregular pulse (arrhythmia)
approach to diagnose hypercalcaemia
identify presence of renal failure (Tertiary hyperparathyroidism)
check on serum PTH
if PTH high and urine calcium excreteion >0.01mmol/l primary hyperparathyroidism
FHH (Familial hypocalciuric hypercalcemia)
- PTH high, urine calcium excretion <0.01mmol
hypercalcaemia of malignancy
most due to bony metastases
other due to PTHrP release
consequences of hyperparathyroidism and cause
osteoporosis
kidney stones
confusion
constipation
most due to benign adenoma
