Hypercalcaemia and Hypocalcaemia Flashcards
define Hypercalcaemia and Hypocalcaemia
High or low levels of calcium in the blood
what are the other causes of hypercalcaemia?
-Multiple myeloma
-Granulomatous diseases (TB and sarcoidosis)
-Dehydration
-Drugs (thiazides, diuretics, lithium, and excessive vit. D or A intake)
what is the most common cause of hypercalcaemia?
hyperparathyroidism
describe the presentation of hypercalcaemia
- Stones - kidney
-Bones - excess resorption, osteopenia
-Groans - abdominal pain, constipation
-Moans - confusion, depression, anxiety
-Thrones - polyuria and polydipsia
what is the presentation for hypercalcaemia the same as?
hyperparathyroidism
what does an ECG with hypercalcaemia have?
Short QT Interval
Short ST Segment
what is the effect on hypercalcaemia on muscles?
Low muscle tone and contractions
Due to Ca inhibiting fast Na influx
what will happen to PTH in hypercalcaemia?
PTH will decrease due to negative feedback (except in hyperparathyroidism).
what is the treatment of hypercalcaemia?
Aggressive IV fluids
If unsuccessful, consider IV bisphosphonates
Treat the underlying cause
what are the causes of hypocalcaemia?
-CKD (due to decreased vit D activation)
-Severe vit D deficiency
-Primary hypoparathyroidism
-Acute pancreatitis
-Drugs (Bisphosphonates, Phenytoin, Loop diuretics, Cinacalcet)
what is the presentation for hypocalcaemia the same as?
Same as in Hypoparathyroidism
describe the presentation of hypocalcaemia
Paraesthesia
Tetany (involuntary muscle contractions)
Chvostek sign
Trousseau sign
what does an ECG with hypocalcaemia have?
Longer QT interval
Longer ST segment
what is the effect of hypocalcaemia on muscles?
-Muscle spasms in hands, feet, larynx
-Premature labour
what will happen to PTH in hypocalcaemia?
PTH will increase due to positive feedback (except in hypoparathyroidism).
