Paulson - Calcium Flashcards
nl serum Ca
9-10.5
mild hypercalcemia
10.5-12
life threatening hypercalcemia
Ca > 14
major causes of hypercalcemia
malignancy
hyperparathyroidism
3 malignancy causes of hypercalcemia
ectopic secretion of pth by tumor
mm
bone mets
endocrine and __ diseases can cause hypercalcemia
ganulomatous →
sarcoidosis, tb
major class of drugs that causes hypercalcemia
thiazide diuretics
lithium
what do you think when you see, milk alkali syndrome
hypercalcemia rt TUMS
mc cause of hypercalcemia in hospitalized pt
malignancy
mc cause of hypercalcemia in op setting
hyperparthyroidism
sx of hypercalcemia
stones
bones
moans
thrones
abd groans
psychiatric moans
also fatigue, anxiety
sx of severe hypercalcemia
lethargy
ams
sz
coma
ekg abnormalities
4 dx steps for hypercalcemia
- check serum Ca → if low
- re-check serum Ca
- if low → confirmed
- measure PTH
2 types of serology for Ca
ionized
total Ca
can also check urine Ca
ionized Ca includes
unbound Ca
serum Ca includes (2)
bound and unbound Ca
most bound Ca is bound to
albumin
if serum albumin is low, you must use
corrected Ca
what type of Ca must be corrected for albumin
serum Ca
after confirming hypercalcemia and checking PTH, if PTH is low you should
check vit D and PTHrP