Hypercalcémie Flashcards

1
Q

Étiologies hypercalcémie

A
1/ neoplasies : paranéo métastases...
2/ hyperparathyroidie primaire
3/ immobilisation prolongée
4/ iatrogene : vit D, diurétique thiazidique,Vit A ,calcémiant,lithium
5/ hyperthyroidie
6/ insuffisance surrenalienne
7/ sarcoidose
8/myelome
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2
Q

Ecg de hypercalcémie

A
TA RAQUETTE PLATE PERD SON RYTHME
TA= tachycardie sinusal
RAQUETTE= racourssiss QT
PLATE: applatiss T
PERD: PR allongé
SON RYTHME: tdr
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3
Q

Formule calcemie corrigee

A

Ca c= CA mesuree+ 0,025(40-ALB)

CA c=CA mesuree+(40-Alb/40)

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4
Q

Chirurgie de hyperparathyroidie primaire dut adenome parathyroidien unique si

A

1/ calcemie> 0,25 mol a la n
2/ 400mg/24h
4/ creat

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5
Q

Diagnostiques devant une bourse aigue douloureuse

A
1/ torsion cordon spermatique
2/ torsion annexe testiculaire : hydatide
3/ cancer testicule
4/ traumatisme scrotal
5/ hernie inguinal engoué ou étranglée
6/ orchiepididymite
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6
Q

Clinique hyercalcemie

A

1/ renal
dec par pupd, lithiase renale,nephrocalcinose, IR

2/ DIG
Nausee voli, dlr abdo, CONSTIPATION ( alcalose metabolique)

3/ NEUROPSY
confusion, apathie, depression, delire

4/ CARDIO
Hta, ecg : racorr Qt, bav1, …taraquette plate perd son rythme
5/ tb coagulation car facteur coag

6/ calcification ectopique : CCA, lithiase biliaire, pa creatite aigue, nephrocalcinose et lithiase, os : osteite fibrokystique de von rick

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7
Q

Ttt hypercalcemie

A

EER >3,7

1/ arret de tout ttt de la triade de la mort: digitalique, hypokaliemie, hypercalcemie

2/ REHYDRATER IV RADIDE ET MASSIVE

3/ biphosphonate IV

CORTICO SSI myelome, hemopathie

HBPM PREVENTIF

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8
Q

Biologie HYPERPARATHYROIDIE PRIMAIRE

dg diff

A

Hypercalcemie
Hypophosphoremie
Hypercalciurie
Hyperphosphaturie

Pth 1,84 augmenté

Dg diff: hypocalcemie familiale benigne
Lithium

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9
Q

Ex complementaire hypercalcemie chronique

A

Dg positif=biologique

Pré ttt chir: echo cervical et scibtigraphieMIBI (bhcg femme enceinte)

Complication
Renale: urre creat bu echo r ou tdm non inj, proteinurie 24h iono sg et u
Hemato : nfs, epp,tp tca, epu
DMO

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10
Q

Si <40 ans et hypercalcemie chronique hhp

Que rechercher

A

NEM 1 et NEM 2 a

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