Hypercalcemia

Question 1

what are the signs and symptoms of hypocalcemia?

Answer 1

nephrolithiasis
bone pain/fractures
abdominal pain/nausea/vomiting
lethargy/depression

Question 2

what are the psych feelings of hypercalcemia?

Answer 2

lethargy/depression

Question 3

what happens to heart with hypercalcemia?

Answer 3

hypertension and short QT

Question 4

what can happen at kidneys in hypercalcemia?

Answer 4

nephrolithiasis

Question 5

name the five steps to immobilization in acute hypercalcemia crisis

Answer 5

anorexia
polyuria
dehydration
impaired mentation
immobilizatin

Question 6

what medications can lead to hypercalcemia?

Answer 6

lithium and thiazides

Question 7

can vitamin D lead to hypercalcemia?

Answer 7

yes if in excess

Question 8

what is a systemic disease that can cause hypercalcemia? how?

Answer 8

sarcoid…may have 1-25 D producing granulomas

Question 9

explain why malignancy can lead to hypercalcemia

Answer 9

malignancy may be producing PTHrp 
or
producing 1,25-D
or 
lytic destruction like MM

Question 10

what lung cancer can hypercalcemia? why?

Answer 10

squamous cell cancer of lung bc it makes PTHrp

Question 11

do malignancies with hypercalcemia have low or high pTH?

Answer 11

usually PTH is normal

Question 12

does vitamin D excess caused hypercalcemia lead to increased or decreased PTH?

Answer 12

normal

Question 13

does medication induced hypercalcemia lead to high or low PTH?

Answer 13

normal

Question 14

what is classic cause of primary parahyperthyroid

Answer 14

adenoma producing PTH in parathyroid

Question 15

what are lab findings in primary hyperparathyroid?

Answer 15

calcium up
PTH up
phosphorus down

Question 16

What happens to urine Ca in primary hyperparathyroid?

Answer 16

urine calcium is increased

Question 17

what is treatment for primary hyperparathyroid from adenoma?

Answer 17

surgical removal

Question 18

what is med option for primary hyperparathyroid from adenoma?

Answer 18

cinacalcet

Question 19

what causes tertiary hyperparathyroid?

Answer 19

kidney disease with a kidney transplant…normally kidney disease leads to high PTH levels but low Ca and then once you have transplant you still have the high PTH but calcium now retained

Question 20

what is FHH?

Answer 20

familial hyperparathyroidsim

Question 21

what happens in FHH?

Answer 21

inactivation of CaSR at the parathyroid

Question 22

what happens due to inactivation of CaSR?

Answer 22

higher calcium levels do not shut of the parathyroid so clacium can continue increasing

Question 23

will the urine calcium be high or low in FHH?

Answer 23

LOW

Question 24

what is first step in diagnosis of FHH?

Answer 24

check calcium level of a relative

Question 25

what two subtypes of MEN can lead to hypercalcemia?

Answer 25

MEN I

MEN IIa

Question 26

what is in charge of cause of MEN IIa

Answer 26

RET

Question 27

name four endocrine diseases that cause hypercalcemia

Answer 27

hyperthyroidism
adrenal insufficiency
pheochromocytoma
VIPoma

Question 28

what happens McCune Albright Syndrome?

Answer 28

constitiutively active GNAS (G protein)

Question 29

what do you see on skin in McCune albright syndrome?

Answer 29

cafe au lait spots

Question 30

what happens to Ca, Vit D, an alk phos in McCUne albright?

Answer 30

Ca up
D up
alk phos up

Question 31

what happens to PTH levels in Mccune albright?

Answer 31

low or normal levels

Question 32

what are symptoms of McCune albright?

Answer 32

fibrous dysplasia,
precocious puberty
other hyperfunctioning endocrinopathies like hyperthyroid and acromegaly