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Y3R5: Medicine I 🩺 > L16: Hypocalcemia & Hypoparathyroidism > Flashcards

L16: Hypocalcemia & Hypoparathyroidism Flashcards

1
Q

Def of Hypocalcemia

A

Serum calcium level below the reference range, (Which is 8.5-10.5)

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2
Q

Causes of Hypocalcemia

A
  • PTH Related (Low - High)
  • PTH Non-Related
  • Drugs
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3
Q

Causes of Hypocalcemia D2 Low PTH

A
  • Congenital
  • Acquired
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4
Q

Causes of Hypocalcemia D2 Low PTH

  • Congenital
A
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5
Q

Causes of Hypocalcemia D2 Low PTH

  • Acquired
A
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6
Q

Causes of Hypocalcemia D2 High PTH

A
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7
Q

Parathyroid hormone resistance

A
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8
Q

Causes of Hypocalcemia Independent on PTH

A
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9
Q

Drugs inducing hypocalcemia

A
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10
Q

CP of Hypocalcemia

A
  • Acute & Chronic Manifestations
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11
Q

Pathophysiology of acute manifestations of Hypocalcemia

A

Increase peripheral neuromuscular irritability

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12
Q

When do Manifestations of Latent tetany appear?

A

Serum calcium:
- 7.5-8 mg / dl.

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13
Q

Manifestations of Latent tetany

A
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14
Q

Chvostek’s sign

A

Facial sign tapping on facial nerve in front of ear twitches of facial muscles.

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15
Q

Peroneal sign

A

tapping on peroneal nerve at the neck of fibula contraction of peroneal muscle

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16
Q

Trousseau’s sign

A

Elevation of blood pressure on the brachial artery above systolic for 3 – 5 minute → carpal spasm

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17
Q

Erb’s sign

A
  • Current less than 4 Milli amperes produce muscular Contraction.
  • Normally, at least 8 Milli ampere required
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18
Q

When does Manifest tetany appear?

A

7 – 7.5 mg / dl

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19
Q

Manifestations of Manifest tetany

A
  • Pain & paresthesia
  • Carpo-pedal spasm
  • Other muscular spasm
  • Convulsion and generalized seizures
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20
Q

Pain & paresthesia in Manifest tetany

A

in the extremities & around mouth

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21
Q

Carpo – pedal spasm in Manifest Tetany

A
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22
Q

Other muscular spasm in Manifest Tetany

A

 Blepharospasm → spasm of eye lid muscles.
 Rhisus sardonicus → spasm of facial muscles.
 Trismus of Jaw → spasm of mastication muscles.
 Laryngismus stridulus → laryngeal muscle spasm.
 Opisthotonus position → spasm of back Ms.
 Spasm of GIT ms → colic.

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23
Q

Blepharospasm

A

 Blepharospasm → spasm of eye lid muscles.

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24
Q

Rhisus sardonicus

A

 Rhisus sardonicus → spasm of facial muscles.

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25
Q

Trismus of Jaw

A

 Trismus of Jaw → spasm of mastication muscles.

26
Q

Laryngismus stridulus

A

 Laryngismus stridulus → laryngeal muscle spasm.

27
Q

Opisthotonus position

A

 Opisthotonus position → spasm of back Ms.

28
Q

Spasm of GIT ms

A

Spasm of GIT ms → colic.

29
Q

Convulsion and generalized seizure in Manifest Tetany

A

In severe hypocalcemia

30
Q

Chronic manifestations of hypocalcemia

31
Q

Chronic manifestations of hypocalcemia

  • Extrapyramidal Disorders
A

 Basal ganglia calcifications
 Leads to parkinsonism, other movement disorders
 Some cases only improve with TTT.

32
Q

Chronic manifestations of hypocalcemia

  • Occular Disease
33
Q

Chronic manifestations of hypocalcemia

  • Dental
A

Dental hypoplasia, failure of tooth eruption, and carious teeth.

34
Q

Chronic manifestations of hypocalcemia

  • skeletal
A

Osteosclerosis, cortical thickening, and craniofacial abnormalities

35
Q

Chronic manifestations of hypocalcemia

  • Ectodermal
A

 Skin: dry, coarse.
 Nail: brittle.
 Hair: loss.

36
Q

Vitamin D deficiency

A
  • Can cause hypocalcemia
  • If severe, lead to rickets and osteomalacia.
37
Q

INVx for hypocalcemia

  • Investigate for Cause
38
Q

INVx for hypocalcemia

  • Confirm the Dx
38
Q

INVx for hypocalcemia

A
  • To Confirm Dx
  • To Identify Cause
  • To Identify Complications
39
Q

INVx for hypocalcemia

  • Investigate for complications
40
Q

TTT of Hypocalcemia

A
  • during Attack
  • TTT of Cause
41
Q

TTT of Hypocalcemia

  • During Attack
A

 1 to 2 g of calcium gluconate can be infused over 10 to 20 minutes.

 Can be repeated.

42
Q

TTT of Hypocalcemia

  • TTT of Cause
43
Q

TTT of Hypocalcemia

  • TTT of Cause (decreased PTH)
A

lifelong calcium and active vitamin D supplementation (calcitriol)

44
Q

TTT of Hypocalcemia

  • TTT of Cause (Decreased Vit D)
45
Q

TTT of Hypocalcemia

  • TTT of Cause (CKD)
A

Phosphate binder, calcium and active vitamin D supplementation (calcitriol).

46
Q

Nature of PHP (In terms of Genetics)

A

A.D disease

47
Q

Pathology in PHP

A

End Organ Resistant “No PTH receptors in kidney and bone “.

48
Q

Characters of PHP (Labs)

A

PTH resistance is characterized by
 Hypocalcaemia
 Hyperphosphatemia
 Elevated PTH concentrations

49
Q

Types of PHP

50
Q

Etiology of PHP type 1

A

 Caused by mutation of GNAS gene coding the alpha subunit of the G protein, which coupled to the PTH receptor

 Leads to inability to activate adenyl cyclase

51
Q

Types of PHP type 1

52
Q

PHP Type 1A

53
Q

PHP Type 1B

54
Q

PHP Type 1C

55
Q

PHP Type 2

  • Nature (Genitically)
56
Q

PHP Type 2

  • CP
A

 All hypo calcemic manifestations
 No features of AHO.

57
Q

PHP Type 2

  • Defect
A

Not Detected

58
Q

TTT of PHP

A

 As Hypoparathyroidism
 Lifelong calcium and active vitamin D

Y3R5: Medicine I 🩺 (47 decks)

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