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MBBS 3: Internal Medicine > Hyper/hypocalcemia > Flashcards

Hyper/hypocalcemia Flashcards

1
Q

Importance of calcium?

A
  1. Heart and skeletal muscle contractility are affected by calcium ions
  2. Vital to nervous system function and are associated with blood clotting and bone mineralization.
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2
Q

Normal calcium range?

A

The concentration of serum calcium is tightly regulated by parathyroid hormone (PTH) and 1,25-hydroxy vitamin D.
Reference ranges: 2.0 - 2.5 mmol/L

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3
Q

Causes of hypercalcaemia?

A
  1. increased bone resorption
  2. increased calscium absorption
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4
Q

Increased bone resorption causes of hypercalcaemia?

A
  1. hyper parathyroidism
  2. malignancy
  3. myeloma
  4. PTH-rp with malignancies
  5. Thyrotoxicosis
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5
Q

Increased calcium absorption causes of hypercalcemia?

A
  1. Increase intake of ca
  2. Increased Vitamin D
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6
Q

Presentation of hypercalcaemia?

A

Malaise
Muscle weakness
Confusion
Nephrolithiasis
Distal RTA

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7
Q

Causes of hypocalcemia?

A
  1. decreased calcium absorption
  2. deposition of calcium/loss
  3. increased renal excretion
  4. others
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8
Q

Decreased calcium absorption causes in hypocalcaemia?

A
  1. Hypoparthyroidisim
  2. Low vitamin d
  3. Hypomagnesemia
  4. malabsorption
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9
Q

Deposition of calcium/loss causes in hypocalcemia?

A

pancreatitis

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10
Q

Increased renal excretion causes in hypocalcemia?

A

diuretics

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11
Q

Other causes of hypocalcaemia?

A
  1. low albumin
  2. alkalosis
  3. hyperphosphatemia
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12
Q

Presentation of hypocalcemia - due to decreased calcium absorption?

A
  1. Neuromuscular excitability
  2. Tetany
  3. seizures
  4. confusion
  5. Hyperreflexia
  6. abnormal eye movements
  7. circumoral tingling
  8. Chvostek’s and Trousseaus’s sign
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13
Q

Bones, Stones, Groans and Moans

A
  1. bones - abnormal bone remodeling and fracture risk
  2. stones - increased risk for kidney stones
  3. groans - abdominal cramping, nausea, ileus, constipation
  4. psychiatric overtones - lethargy, depressed mood, psychosis, cognitive dysfunction
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14
Q

Hypocalcemia signs and symptoms?

A
  1. easy fatigability
  2. depression, anxiety, confusion
  3. numbness and tingling in extremities and region around mouth
  4. hyperreflexia, muscle cramps
  5. Chvosteks sign and Trousseaus sign
  6. laryngeal spasm
  7. tetany, seizures
  8. ventricular tachycardia
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15
Q

Treatment of hypercalcemia?

A
  1. Treat cause
  2. Adequate rehydration 3-4 l/day
  3. Intravenous bisphosphonates
  4. Loop diuretics
  5. Dialysis in extreme cases
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16
Q

Treatment hypocalcemia?

A
  1. Treat Cause
  2. Oral Calcium supplements
  3. Intravenous calcium gluconate
  4. Vitamin D3

MBBS 3: Internal Medicine (72 decks)

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