Calcium Disorders Flashcards
(27 cards)
What are common causes of Hypercalcemia?
Primary Hyperparathyroidism (PTH)
Vit D Intoxication
Sarcoidosis
Thiazide Diuretics
hyperthyroidism
Mets to bone and Multiple Myeloma
What is the most common cause of Hypercalcemia?
Primary Hyperparathyroidism (PTH)
What are common symptom caused by hypercalcemia?
Confusion, Stupor, Lethargy
Constipation
Short QT and Hypertension
Osteoporosis
Nephrolithiasis, DI, Renal Insufficiency
How do you treat Hypercalcemia?
Saline Hydration: high volume
Bisphosphonates: Pamidronate, Zoledronic acid
calcitonin: works faster than bisphosphonates
Prednisone if caused by granulomatous disease
How does Calcitonin work?
Inhibits osteoclasts
What are the major causes of Primary Hyperparathyroidism?
Solitary Adenoma
Hyperplasia of all 4 glands
Parathyroid malignancy
What are common slower onset manifestations of Hyperparathyroidism?
Osteoporosis
Nephrolithiasis and renal insufficiency
Muscle weakness, anorexia, nausea, vomiting and abdominal pain
Peptic Ulcer disease: Calcium stimulates gastrin
What lab values are seen with hyperparathyroidism?
High Ca, High PTH
Low PO4, High Cl
Short QT on EKG
ALK may be increased
What is the treatment for Primary Hyperparathyroidism?
Surgical removal
What are indications for parathyroid removal?
Bone Disease: osteoporosis
Renal involvement: Including stones
Age <50
Ca consistently 1 point above normal
What drug is used to treat hyperparathyroidism if surgery is not possible?
Cinacalcet
What is the mechanism of Cinacalcet?
Inhibits the release of PTH
What drug is used for secondary Hyperparathyroidism?
Etelcalcetide
What are common causes of Hypocalcemia?
Prior neck surgery: Thyroidectomy
Hypomagnesemia
Renal Failure
Vitamin D deficiency
Genetics
Fat Malabsorption
Low albumin states
How does Hypocalcemia present?
Signs of Neural Hyperexcitability
What are common symptoms of Hypocalcemia?
Chvostek Sign: facial Nerve
Carpopedal spasm
Perioral numbness
Mental irritability
Seizures
Tetany: Trousseau sign
What does EKG show in hypocalcemia?
Prolonged QT that may lead to arrhythmia
What does Slip limp exam show in Hypocalcemia?
Early Cataracts
How do you treat Hypocalcemia?
Calcium replacement and activated Vitamin D
What is Paget Disease of Bone?
Osteoclasts and Osteoblasts work out of sync leading to deformed bone
What can Paget Disease of bone develop into?
Osteosarcoma
What are common symptoms/findings in Paget Disease of Bone?
Elevated Alk phos with normal GGTP
Risk of hearing loss from Nerve compression
What is seen on X-ray for Paget Disease of Bone?
Mixed lytic/sclerotic lesions
What is the most accurate test for Paget Disease of Bone?
Technetium Nuclear Bone scan: shows patchy areas of osteoblastic activity
