hyper & hypocalcaemia Flashcards
1
Q
What are the 2 most common causes of hypercalcaemia?
A
- primary hyperparathyroidism
- hypercalcaemia of malignancy
2
Q
What are some other causes of hypercalcaemia?
A
- sarcoidosis
- acromegaly
- vit D intoxication
- addison’s
- thiazide’s
- addison’s
3
Q
What are the symptoms of hypercalcaemia?
A
- bones - boney pain + arthralgia
- stones - kidney stones
- thrones -polyuria + dipsia = sitting on the pisser
- groans - abdominal pain/constipation/pancreatitis
- psychiatric MOANS - anxiety/depression/fatigue/cognitive dysfunction
4
Q
How do you treat hypercalcaemia?
A
- aggressive fluid rehydration 3-4 litres
- bisphosphonates thereafter
5
Q
What are the 3 mechanisms involved in hypercalcaemia of malignancy?
A
- paraneoplastic production of PTH - squamous cell, bladder, renal, breast and ovarian cancers
- ectopic Vit-D production - hodgkins & non-hodgkin’s lymphomas
- osteolytic activity from boney mets
6
Q
What investigation’s would you do when hypercalcaemia is suspected?
A
- corrected calcium
- PTH levels - differentiate between parathyroid and none PTH causes
- ECG - check for QT shortening & J waves
7
Q
What are the symptoms of hypocalcaemia?
A
- muscle cramps/spasming
- tetany
- perioral parasethia
- ECG - prolonged QT
- chronic: depression + cataracts
8
Q
2 weird eponymous signs for hypocalcaemia?
A
- chovstek’s - facial muscle twitching parotid tap
- traussaeu’s - tetany on BP cuff inflation
9
Q
what are the causes of hypocalcaemia?
A
- hypoparathyroidism
- Vit D deficiency
- pseudohypoparathyroidism
- rhabdomyolysis
- magnesium deficiency
- massive blood transfusion
- acute pancreatitis
10
Q
Treatment of hypocalcaemia?
A
- treat underlying cause
- calcium gluconate 10ml 10% solution in 10 mins
