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Endocrine clinical conditions > Hypercalcaemia > Flashcards

Hypercalcaemia Flashcards

1
Q

what level of Ca is hypercalcaemia?

A

> 3.0 mol/L

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2
Q

what level of Ca in hypercalcaemia requires treatment?

A

symptomatic 3.0-3.5 mol/L

> 3.5 mol/L urgent correction

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3
Q

what are the 2 main causes of hypercalcamia?

A 
malignancy
primary hyperparathyroidism (sporadic)
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4
Q

what endocrine disorders can cause hypercalcaemia?

A

phaechromocytoma
acromegaly
hyperthyroidism
adrenal insufficiency

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5
Q

what are the clinical features of hyperparathyroidism (resulting in hypercalcaemia)?

A

bones, stones, groans, psychic moans
bone pain, osteopenia, osteoporosis
polyuria, polydipsia, renal calculi, distal renal tubular acidosis, nephrogenic diabetes insipidus
anorexia, nausea, vomiting, constipation, pancreatitis, peptic ulcer
decreased concentration, confusion, paranoia, fatigue, coma
shortening of QT, bradycardia, hypertension

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6
Q

what blood tests would you carry out if someone had hypercalcaemia?

A 
U&E's
Ca
phosphate
PTH
alkaline phosphate
myeloma screen (multiple myeloma)
Serum ACE (sarcoidosis)
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7
Q

in what age and sex is primary hyperparathyroidism more common in?

A

F > M 3:1

50-60 yrs

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8
Q

what causes primary hyperparathyroidism?

A

majority is sporadic - parathyroid adenoma

however can occur due to neck irradiation or prolonged lithium use

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9
Q

how would you investigate the site primary hyperparathyroidism ?

A

parathyroid ultrasound
SESTAMIBI
CT

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10
Q

what is the treatment for primary hyperparathyroidism?

A

fluids
cinacalcet (mimics Ca on Ca receptors in PT gland)
parathyroidectomy

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11
Q

what is familial hypocalciruric hypercalcaemia?

A

autosomal dominant disorder of the Ca sensing receptor
it mimics hyperparathyroidism
no structural abnormality of PT glands

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12
Q

what is the management for hypercalcaemia?

A 
IV saline 
IV bisphosphonates (zolendronic acid)

2nd line:

  • glucocorticoids
  • calcitonin
  • calcimetrics
  • parathyroidectomy
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13
Q

what types/genes of multiple endocrine neoplasia cause hyperparathyroidism?

A

MEN 1 and MEN 2A

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14
Q

what investigations would you carry out if you suspected primary hyperparathyroidism?

A

Ca
PTH
U&E
abdominal imaging i.e. peptic ulcers, renal calculi etc
DEXA - osteoporosis
24 urine collection for Ca - exclude FHH
vitamin D

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15
Q

why would you do a 24 hour urine Ca in someone who presented with hypercalcaemia?

A

to exclude familial hypocalciruric hypercalcaemia

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16
Q

what are the functions of ca in the body?

A

muscle contraction

Endocrine clinical conditions (12 decks)

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