Hypercalcemie Flashcards

0
Q

Formule Ca total corrige

A

Ca corr =Ca mesure (mmol/L)+(40-albu)/40

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1
Q

Calcémie normale

A

2,2-2,6 mmol/L

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2
Q

Clinique hypercalcemie

A

DIG (nausées, vomis, dlrs, anorexie) ; NEUROPSY (céphalées,asthénie, hypotonie/hyporeflexie,confusion…) REIN (polyuro-dypsie, IR, HTA, lithiase..), CARDIO, AEG

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3
Q

Signes hypercalcemie majeure

A

Déshydratation (/!\IRn), fièvre, obnubilation, dlrs abdo/vomis, tb cardio

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4
Q

Bio hyperCa majeure

A

Ça > 3,5mmol/L, DEC (prot augmente, augm Ht), alcalose métabolique (sauf IRnC et HPTH), hypoCl, hypoK

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5
Q

Principes traitement d’urgence

A

Stop potentialiseurs, NaCl9% 3-6L/24h +/-lasilix (si IRn ou IC), calcitonine (5u/kg/j en 3x) + BP IV

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6
Q

Paraclinique hypercalcemie

A

Ca, P, Cau, Pu, creatu 24h, NFS-Pq, iono, VS CRP, créat, EPS,PTH, vit D, RP, ECG

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7
Q

Étiologies des hypercalcemie

A

Neo (50% : meta os, MM, lymphome, hyperCa humorale maligne) HPT primitive (40%), intox vit D ou A, lithium, diurétiques thiaz; granulomatose, hyperCa-hypoCau-fam, sd lait et alcalins, immobilisation, IRnC, NEM, hypothyro, ISA,pheo

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8
Q

Traitements potentialiseurs

A

Digitaliques, alcalins, Ca et vit D, diurétique et hypoK

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9
Q

Physiopathologie HPTH primitive

A

Sécrétion +++ PTH > absorption Ca + reabs tubu Ca + et reabs P - et reabs os +

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10
Q

Clinique HPTH primitive

A

Asympt, OS (dlrs meca, #, ostéite fibrokystique de bon Reck..), REIN(lithiase), UGD, pancréatite calcifuge aiguë, HTA, Chondricalcinose…

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11
Q

Étiologies HPTH primitive

A

Adénome parathyro +++ (svt unique, penser NEM 1 ou 2a)
Hyperplasie diffusé des parathyroides
Carcinome

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12
Q

Par aclinique HPTH

A

Cf hyperCa

+ écho cervic, scintig +/- scanner ou IRM

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13
Q

Prise en charge HPTH

A

Chir (cervicotomie explo des 4 glandes et si hyperplasie diffuse : excision 3/4)
Surv
BP ou calcitonine

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14
Q

Surveillance HPTH primitive

A

Ca/6 mois, créat/an, DMX/an

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15
Q

Indications chir HPTH

A

Sympt ou >2,85 ou Cau>10/24h, Clairance<-2.5