Endocrinology Flashcards
What are some of the physio logic roles of Ca?
Neuromuscular transmission, muscle contraction, blood coag, bone, hormones
Where is the highest percentage of extracellular Ca found?
Ionized or biologically active
What are the three things that control calcium homeostasis?
PTH, Calcitonin, Vit D
What is PTH secreted in response to?
Low Ca or high P
What does PTH do?
Increases Ca mobilization from bone, renal tubular reabsorption, urinary loss of phosphorus, formation of calcitrol in kidney
What is calcitonin secreted in response to?
Rise in free calcium, inhibits bone resorption of Ca
What is the biologically active form of Vit D?
Calcitriol
What are the signs of hypercalcemia?
May be none , PU/PD is most common also lower urinary, weakness, decreased activity.
What are the differentials for hypercalcemia?
Ggranulomatous Osteolysis Sepsis Hyperparathyroidsm D toxicosis Addisons Renal N eoplastic Idioplasthic Temperature
What are the differentials for a patient with High Ca and Low P?
Primary hyperparathyroidism
hypercalcemia of malignancy
Renal disease
What are the differentials for a patient with high Ca and high P?
Renal, Addison’s, hypervitaminosis D
If the Ca-P is greater than >70 should you be concerned?
yes! Tissue mineralization and nephron damage
What is the most common cause in dogs for hypercalcemia? Cats?
neoplasia in dogs, idiopathic in cats
What is something on PE that you should automatically think hypercalcemia if you see?
Rubber jaw and urine SG
What is primary hyperparathyroidism?
Syndrome of excess PTH, with clinical signs that are due to hypercalcemia. Typically from adenoma of parathyroid gland.
What are some things that are not normal on a PHPT diagnosis?
high ca, low P, calcium crystals, hematuria, inflammation.
What is the most suggestive thing an a calcium profile that is suggestive of PHPT?
Increased PTH in the face of hypercalcemia
What are your treatment options for hypercalcemia? when should you treat?
When Ca x P>70, use fluid therapy, furosemide, glucorticoids, pamidronate
What is the treatment of choice for PHPT?
Surgical parathyroidectomy