Calcium Flashcards
What does acute hypercalcaemia present as?
Thirst
Dehydration
Confusion
Polyuria
Causes of hypercalcaemia?
Primary hyperparathyroidism
Malignancy
Some less common ones:
granulomatous disease
Familial hypocalciuric hypercalcaemia
High turnover (bedridden, thyrotoxic, Paget’s)
What is the algorithm for investigating hypercalcaemia?
Hypercalcaemia acute treatment
Fluids - rehydrate
- Consider loop diuretics (avoid thiazide)
-
What is the scan for parathyroid?
Sestamibi scan
What are indicators for parathyroidectomy?
End Organ Damage (bone disease, gastric ulcers, renal stones, osteoporosis)
Very high Calcium (>2.85mmol/l)
Under age 50
eGFR < 60 mL/min
How to differentiate primary, secondary, tertiary?
What are symptoms of hypocalcaemia?
Paraesthesia - fingers, toes, perioral
Muscle cramps, tetany
Muscle weakness
Fatigue
Bronchospasm or laryngospasm
Fits
Chovsteks sign (tapping over facial nerve)
Trousseau sign (carpopedal spasm)
ECG: QT prolongation
How to manage acute hypocalcaemia?
IV calcium gluconate
What are causes of hypoparathyroidism?
How to manage long-term hypoparathyroidism?
What is hypomagnasaemia?
What is pseudohypoparathyroidism?
What is pseudo-pseudohypoparathyroidism?
