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Flashcards in Calcium disorders Deck (13)
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1
Q

What is the most common cause of hypercalcemia, and what are the symptoms

A

Primary hyperparathyroidism - normally asymptomatic

If symptomatic and bad, think cancer releasing PTH

2
Q

What are other causes besides hyperparathyroidism for high calcium

A

Vitamin D intoxication, sarcoidosis, thiazide diuretics, hyperthyroidism, metastases to bones

3
Q

What is the presentation of acute symptomatic hypercalcemia

A

Confusion, stupor, lethargy, constipation

CV - short QT

Bones - osteoporosis
Renal - nephrolithiasis, diabetes insipidus, renal insufficiency

4
Q

What is the treament of acute hypercalcemia

A

Saline hydration with loop diuretic (furosemide)

Also bisphosphonates: Pamidronate, zoledronic acid

Second line after they don’t work: Calcitonin (not calacalcet, which inhibits PTH but doesnt help in malignancy)

Dialysis if renal failure

5
Q

What is the treatment of acute hypercalcemia if the source is sarcoidosis or other granulomatous diseases

A

Prenisone

6
Q

If hyperparathyroidism is the cause of high calcium, what are the 3 ways this can occur

A

Solitary adenoma - 80%

Hyperplasia of all 4 glands (15%)
Parathyroid malignancy - 1%

7
Q

What is the presentation if hyperparathyroidism is the cause of high calcium

A

More slower manifestations rather than acute symptoms, such as osteoporosis, nephrolithiasis and renal insufficiency, NV, muscle weakness, abdominal pain, peptic ulcer disease

8
Q

What are the diagnostic tests you can do for hyperparathyroidism

A

High calcium, high PTH, high Cl, EKG with short QT

DEXA scan

9
Q

What is the main treatment for hyperparathyroidism

A

Surgical removal

10
Q

What are four causes of hypocalcemia

A

Hypoparathyroidism - prior neck surgery
Hypomagnesemia - results in low PTH

Renal failure - Due to less 1,25 vit D
Low albumin states - Every point decrease in albumin means calcium decreases by 0.8 (free calcium normal so no symptoms)

11
Q

What is the presentation of someone with hypocalcemia

A

Chostek sign, Trousseau sign, carpopedal spasm, periooral numbness, seizures

12
Q

What are diagnostic tests that you can use for hypocalcemia

A

EKG - prolonged QT

Slit lamp - early cataracts

13
Q

What is the treatment for hypocalcemia

A

Replace calcium and vitamin DIfmild - oralIf severe - IV