Misc

Question 1

HYPERCALCEMIA does what to nerves?

Sx associated?

Answer 1

Hypercalcemia reduces gradient for sodium influx into nerve cells- so LESS DEPOLARIZATION of nerves
Sx: 
fatigue
cognitive impairment 
MUSCLE WEAKNESS/ TONE
diminished reflexes 

severe hypocalcemia causes coma and cardiac arrest

Question 2

Hypocalcemia does what to nerves?

Sx associated?

Answer 2

increase sodium influx into cells so HYPEREXCITABILITY because cell gets easily depolarized
Sx:
normal stimulation of e.g. skin or muscle will give a HYPER RESPONSE- so
muscle cramps and abdominal pain
Trousseau sign (blood pressure cuff cause finger spasming)
Chvostek sign (tap cheek (facial nerve)

severe hypocalcemia:
TETANY,
SEIZURE

Question 3

Tx of severe hypercalcemia?

what to give first and second

Answer 3

1st: saline and calcitonin
2nd: bisphosphonates

Question 4

Tx of acute hypocalcemia

Answer 4

CALCIUM GLUCONATE

Question 5

What is hypercalcemia induced nephrogenic diabetes insipidus?

Answer 5

hypercalcemia causes afferent artery vasoconstriction, reduced GFR,
reduced GFR means reduced HCO3- reabsorption so high hco3- in blood
hypercalcemia also DISRUPTS NKCCl2 cotransporter- so less sodium reabsorbed= DIURESIS- polyuria

Question 6

Young man intermittent Abdominal pain and proximal motor weakness, found to have elevated porphobillinogen, and Sx when on sulfa drugs –> Dx?

Answer 6

Acute intermittent porphyria- congenital- but Sx dont show unless hormonal changes, diet changes or certain medication use etc.