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Y4R1 - Pediatrics I 👶 > L7: Hypocalcemia > Flashcards

L7: Hypocalcemia Flashcards

1
Q

Distribution of Ca in the body

A
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2
Q

Soluble calcium in the blood

  • Derived From
A
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3
Q

Soluble calcium in the blood:

  • Forms
A
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4
Q

Normal serum calcium

A

8.5 - 10.5 mg/dl

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5
Q

Normal Ionized calcium

A

4.5 - 5.1 mg/dI

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6
Q

Hormonal control of calcium level

A
  • Parathyroid Hormone
  • Vitamin D
  • Calcitonin
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7
Q

Fetal development of parathyroid gland

A
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8
Q

Characters of Parathyroid hormones

A
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9
Q

Regulation of Parathyroid hormones

A
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10
Q

Physiology of Parathyroid hormones

A
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11
Q

Effects of Parathyroid hormones

A
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12
Q

Effects of Parathyroid hormones

  • on Bone
A
  • calcium mobilization by osteoblast-mediated activation of bone-resorbing osteoclasts.
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13
Q

Effects of Parathyroid hormones

  • On Kidney
A
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14
Q

Effects of Parathyroid hormones

  • on GIT
A
  • Indirectly increase absorption of Ca and phosphate through vitamin D
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15
Q

Nature of Vit D

A

Fat-soluble steroid

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16
Q

Types of Vit D

A
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17
Q

Synthesis of Vit D

A
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18
Q

Effects of Vit D

A
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19
Q

Characters of Calcitonin

A

Peptide produced by thyroid parafollicular C celle

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20
Q

Regulation of Calcitonin

A

increase in serum Ca —-> Increase in Calcitonin secretion

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21
Q

Physiology of Calcitonin

A

Calcitonin acts via protein-coupled receptor

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22
Q

Effects of Calcitonin

A
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23
Q

Causes of hypocalcemia

A
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24
Q

Etiology of Hypoparathyroidism

A
  • Congenital
  • Acquired
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25
Q

Etiology of Hypoparathyroidism

  • Congenital
A
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25
Q

Etiology of Hypoparathyroidism

  • Acquired
A
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26
Q

Etiology of DiGeorge Syndrome

A
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27
Q

CP of DiGeorge Syndrome

A
  • Cardiac
  • Face
  • Neck & Mediastinum
  • Mentality
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28
Q

CP of DiGeorge Syndrome

  • Cardiac
A
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29
Q

CP of DiGeorge Syndrome

  • Eyes
A
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30
Q

CP of DiGeorge Syndrome

  • Nose
A
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31
Q

CP of DiGeorge Syndrome

  • Ears
A
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32
Q

CP of DiGeorge Syndrome

  • Mouth
A
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33
Q

CP of DiGeorge Syndrome

  • Neck & Mediastinum
A
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34
Q

CP of DiGeorge Syndrome

  • Mentality
A
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35
Q

Def of PHP

A
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35
Q

Dx of PHP

A
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35
Q

Special Types of PHP

A

Pseudo - hypoparathyroidism type 1A (PHPIA) (Albright hereditary osteodystrophy)

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36
Q

CP of Type 1A (PHPIA) (Albright hereditary osteodystrophy)

A
  • Hand
  • MSK
  • Mentality
  • Head
37
Q

CP of Type 1A (PHPIA) (Albright hereditary osteodystrophy)

  • Hand
38
Q

CP of Type 1A (PHPIA) (Albright hereditary osteodystrophy)

  • MSK
A
  • Short stature
  • Subcutaneous ossifications
39
Q

CP of Type 1A (PHPIA) (Albright hereditary osteodystrophy)

  • Mentality
A

Mild or moderate mental retardation

40
Q

CP of Type 1A (PHPIA) (Albright hereditary osteodystrophy)

  • Hand
A
  • Round face
  • Dental defects
  • Sensory-neural abnormalities
42
Q

Etiology of Vit D Deficiency

A
  • Decreased Intake
  • Decreased absorbtion
  • Decreased Production
  • Increased Excretion
43
Q

Etiology of Vit D Deficiency

  • Nutritional
44
Q

Etiology of Vit D Deficiency

  • Absorbtion
45
Q

Etiology of Vit D Deficiency

  • 25-Hydroxyvitamin D Related Causes
46
Q

Etiology of Vit D Deficiency

  • 1,25 - Dihydroxyvitamin D Related Causes
47
Q

Effects of Severe Hypomagnesemia

A
  • Deficient PTH secretion
  • Diminished target-cell response.
48
Q

Etiology of Hypomagnesemia

A
  • Familial hypomagnesemia
  • Malabsorption
  • Renal tubular disorders (Bartter, Gitelman, …)
49
Q

Etiology of Inorganic Phosphate Excess

A
  • Increased Intake
  • Decreased Excretion
  • Spurious
  • Phosphate Shift
50
Q

Etiology of Inorganic Phosphate Excess

  • Increased Intake
A
  • Poisoning
  • Oral or parenteral excess administration
  • Milk-alkali syndrome
  • Vitamin D intoxication
51
Q

Etiology of Inorganic Phosphate Excess

  • Decreased Excretion
A
  • Renal failure (acute or chronic)
  • Hypoparathyroidism
  • Severe hypomagnesemia
  • Bisphosphonate therapy
52
Q

Etiology of Inorganic Phosphate Excess

  • Spurious
A

Pseudo - hyperphosphatemia:

  • Blood sample taken from line containing heparin
  • In vitro hemolysis
  • Hyperbilirubinemia
  • Hyperlipidemia
53
Q

Etiology of Inorganic Phosphate Excess

  • Potassium Shift
A
  • Rhabdomyolysis
  • Tumor lysis syndrome
  • Acute hemolysis
  • Acute metabolic or respiratory acidosis
54
Q

CP of Hypocalcemia

55
Q

CP of Hypocalcemia

  • NMJ
A
  • Tetany
  • Permanent mental deterioration (longstanding, not-treated)
56
Q

CP of Hypocalcemia

  • Head
57
Q

CP of Hypocalcemia

  • Autoimmune
58
Q

CP of Hypocalcemia

  • MSK
A
  • Horizontal lines over the nails
  • Permanent physical deterioration (longstanding, not-treated)
59
Q

Def of Tetany

A
  • State of hyperexcitability of the neuromuscular system due to decreased ionized calcium in the blood
60
Q

Types of Tetany

61
Q

Relation between pH & Tetany

62
Q

CP of Tetany

63
Q

CP of Latent Tetany

64
Q

CP of Latent Tetany

  • Chovstek sign
A

Tapping of facial nerve in front of the ear lead to spasm of facial muscles of same side

65
Q

CP of Latent Tetany

  • Trousseau Sign
A
  • Compress upper arm with sphygmomanometer cuff with sphygmomanometer cuff with pressure between systolic and diastolic lead to carpal spasm
66
Q

CP of Latent Tetany

  • Erb’s Sign
A

Low galvanic current (<5mAm) lead to muscle contraction

67
Q

CP of Latent Tetany

  • Peroneal Sign
A

Tap peroneal nerve near head of fibula lead to pedal spasm

68
Q

CP of Manifest Tetany

69
Q

CP of Manifest Tetany

  • Carpal Spasm
70
Q

CP of Manifest Tetany

  • Pedal Spasm
A

Foot extended in position of talipes equinus position with flexion of toes

71
Q

CP of Manifest Tetany

  • Laryngeal Spasm
A

Attacks of spasmodic closure of the larynx (stridor)

72
Q

CP of Manifest Tetany

  • Convulsions
A

With loss of consciousness

73
Q

INVx for Hypocalcemia

A
  • Labs
  • Rads
  • EP
74
Q

INVx for Hypocalcemia

  • Labs
75
Q

INVx for Hypocalcemia

  • Confirmation
A

Total & ionized Ca

76
Q

INVx for Hypocalcemia

  • Other Abnormalities
A
  • Renal function and creatinine clearance
  • Serum phosphate & Mg
77
Q

INVx for Hypocalcemia

  • PTH
78
Q

INVx for Hypocalcemia

  • Other Studies
79
Q

Hypocalcemia & Addison’s Disease

80
Q

INVx for Hypocalcemia

  • Rads
81
Q

INVx for Hypocalcemia

  • ECG & EEG
82
Q

Lab INVx for different causes of hypocalcemia

83
Q

TTT of Hypocalcemia

A
  • Emergency
  • Maintainence
84
Q

TTT of Hypocalcemia

  • Emergency TTT
85
Q

Emergency TTT of Hypocalcemia

  • Calcium Gluconate
86
Q

Emergency TTT of Hypocalcemia

  • Calcitriol (1,25 OH D3)
87
Q

Manintenance TTT of Hypocalcemia

88
Q

Manintenance TTT of Hypocalcemia

  • Avoid food rich in PO4
89
Q

Manintenance TTT of Hypocalcemia

  • Vit D
90
Q

Manintenance TTT of Hypocalcemia

  • Calcium
91
Q

Different Oral Ca Salts

92
Q

Alpha Calcidol Perparations (One Alpha)

Y4R1 - Pediatrics I 👶 (49 decks)

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