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Clin Med II - Exam 4 > Paulson - Calcium > Flashcards

Paulson - Calcium Flashcards

1
Q

nl serum Ca

A

9-10.5

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2
Q

mild hypercalcemia

A

10.5-12

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3
Q

life threatening hypercalcemia

A

Ca > 14

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4
Q

major causes of hypercalcemia

A

malignancy

hyperparathyroidism

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5
Q

3 malignancy causes of hypercalcemia

A

ectopic secretion of pth by tumor

mm

bone mets

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6
Q

endocrine and __ diseases can cause hypercalcemia

A

ganulomatous →

sarcoidosis, tb

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7
Q

major class of drugs that causes hypercalcemia

A

thiazide diuretics

lithium

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8
Q

what do you think when you see, milk alkali syndrome

A

hypercalcemia rt TUMS

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9
Q

mc cause of hypercalcemia in hospitalized pt

A

malignancy

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10
Q

mc cause of hypercalcemia in op setting

A

hyperparthyroidism

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11
Q

sx of hypercalcemia

A

stones

bones

moans

thrones

abd groans

psychiatric moans

also fatigue, anxiety

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12
Q

sx of severe hypercalcemia

A

lethargy

ams

sz

coma

ekg abnormalities

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13
Q

4 dx steps for hypercalcemia

A
  1. check serum Ca → if low
  2. re-check serum Ca
  3. if low → confirmed
  4. measure PTH
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14
Q

2 types of serology for Ca

A

ionized

total Ca

can also check urine Ca

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15
Q

ionized Ca includes

A

unbound Ca

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16
Q

serum Ca includes (2)

A

bound and unbound Ca

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17
Q

most bound Ca is bound to

A

albumin

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18
Q

if serum albumin is low, you must use

A

corrected Ca

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19
Q

what type of Ca must be corrected for albumin

A

serum Ca

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20
Q

after confirming hypercalcemia and checking PTH, if PTH is low you should

A

check vit D and PTHrP

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21
Q

elevated PTHrP makes you think

A

malignancy

22
Q

if serum PTH is high think

A

hypercalcemia rt hyperparathyroidism

23
Q

ekg findings associated w. hypercalcemia

A

short qt interval

bradyarythmias

sinus arrest

av blocks

bundle branch blocks

24
Q

pt w. hypercalcemic crisis are usually

A

dehydrated

25
Q

tx for hpyercalcemic crisis

A

IV access → ns “wide open” until bp and perfusion normalize

cardiac monitoring

26
Q

what does “wide open” ns mean

A

highest rate possible

27
Q

what is NOT recommended for tx of hypercalcemia

A

furosemide

28
Q

pharm for hypercalcemia

A

osteoclast-inhibiting

29
Q

ex of osteoclast inhibiting drugs (3)

A

bisphosphonates

calcitonin

glucocorticoids

30
Q

what drug is often used for hypercalcemia dt malignancy

A

bisphosphonates

31
Q

last line tx for hypercalcemia

32
Q

tx for hypercalcemic crisis dt hyperprathyroidism

A

parathyroidectomy

33
Q

ekg finding for hyperCa

ekg finding for hypoCa

A

hyper: short qt
hypo: prolonged qt

34
Q

hypocalcemia def

A

serum Ca < 8.5 → corrected

ionized Ca < 4.6

35
Q

3 mc causes of hypocalcemia

A

impaired pth production

impaired vit D production

renal dz

36
Q

what do you think when you see, hungry bones

A

hpocalcemia rt parathyroidectomy

37
Q

drugs that cause hypocalcemia

A

bishosphonates

ca chealators

phenytoin

fluoride

38
Q

classic sx of hypocalcemia

A

trosseau sign

chvostek sign

39
Q

carpal tunnel spasm after bp cuff is applied for 3 min

A

trosseau sign

40
Q

spasm of facial muscle after tapping facial n in front of ear

A

chvostek sign

41
Q

other sx of hypocalcemia

A

asymptomatic

muscle spasm/cramp

tetany

paresthesias confusion

sz

dry skin, brittle nails, coarse hair

anxiety, dpn, dementia

42
Q

ekg changes of hypocalcemia

A

prolonged qt or st flattening

43
Q

paresthesias rt hypocalcemia

A

perioral

peripheral

44
Q

dx for hypocalcemia

A

total serum Ca → corrected for albumin vs ionized Ca

serum phosphate

vit D

PTH

check for hypomagnesium

bmp

45
Q

ekg change rt hypocalcemia

A

prolonged qt

46
Q

signs of acute/severe hypocalcemia

A

ekg changes

spasms

other severe sx

47
Q

tx for severe hypocalcemia

A

IV calcium gluconate

48
Q

fx for mild hypocalcemia

A

op oral Ca and Vit D

49
Q

what form of Ca repletion is preferred

A

calcitriol

50
Q

most w. hypocalcemia need

A

lifelong Ca/vit D replacement

51
Q

1st step in hypocalcemia tx hypomagnesemia 1st

Clin Med II - Exam 4 (20 decks)

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