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Endocrine > Hypercalcaemia > Flashcards

Hypercalcaemia Flashcards

1
Q

What is the normal level of calcium?

A

2.1-2.6mmol/L

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2
Q

What is a mild increase in calcium?

A

Less than 3mmol/l

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3
Q

What is a moderate increase in calcium?

A

3-3.5mmol/l

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4
Q

What is a severe increase in calcium?

A

More than 3.5mmol/l

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5
Q

What is the rhyme for the symptoms of hypercalcaemia?

A

Stones, Bones, Moans, Groans

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6
Q

What does stones include?

A

Thirsty
Frequently passing urine
Dilute urine
(polyuria and polydipsia)

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7
Q

What does bones include?

A

Bone pain

Increased risk of fracture

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8
Q

What does groans include?

A

Abdominal pain
Nausea
Vomiting
Constipation

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9
Q

What are the main causes of hypercalcaemia?

A

Primary hyperparathyroidism

Malignancy

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10
Q

What does an increase in PTH cause?

A

An increase in calcium in the blood

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11
Q

How can malignancy cause hypercalcaemia?

A

Tumour secretes PTH related protein-
Squamous cell lung cancer

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12
Q

What are more unusual causes of hypercalcaemia?

A 
Thiazide diuretics (increase ca from distal tubule)
Excess vitamin D (increase ca from gut)
Sarcoidosis (rare)
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13
Q

How is hypercalcaemia diagnosed?

A

Serum calcium levels
ECG
PTH (usually main investigation)

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14
Q

What would you see on an ECG with hypercalcaemia?

A

Decreased QT interval

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15
Q

Why would you test serum ACE?

A

For sarcoidosis

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16
Q

What is the management of hypercalcaemia?

A

0.9% IV saline

17
Q

What is the management for weakened bones?

A

Bisphosphonates- Pamidronate

18
Q

What is the management to correct fluid overload?

A

Diuretics- Furosemide

19
Q

What is not necessary for the management of hypercalcaemia?

A

Low calcium diet

20
Q

How does MEN 1 present?

A

Recurrent peptic ulcer
Galactorrhoea
Hypercalcaemia

21
Q

What other endocrine conditions can cause hypercalcaemia?

A

Acromegaly
Addisons

22
Q

What are the main causes of hypercalcaemia?

A

Primary hyperparathyroidism
Squamous cell lung cancer
Bone metastases
Myeloma

23
Q

What medication can be given after rehydration with normal saline?

A

Bisphosphonates

24
Q

When might you consider using loop diuretics such as furosemide?

A

Use in hypercalcaemia in patients who cannot tolerate aggressive fluid rehydration.

25
Q

What does moans include?

A

Lethargy
Fatigue
Memory loss
Psychosis
Depression

26
Q

An excess of which vitamin can cause hypercalcaemia?

A

Vitamin D

27
Q

What is the main drug cause of hypercalcaemia?

A

Thiazide diuretics

Endocrine (27 decks)

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