Flashcards in Calcium Disorders Deck (26)
List clinical features of hypercalcaemia
Abdo pain (renal stones, pancreatitis)
List the main causes of hypercalcaemia
Drugs (vit D, thiazides)
High cell turnover (Paget's)
If you could do one test to investigate hypercalcaemia, what would you do?
Measure PTH levels
Outline management of hypercalcaemia
What is the difference between primary, secondary and tertiary hyperparathyroidism?
Primary: overactivity of PT gland due to adenoma
Secondary: physiological response to low Ca
Tertiary: PT becomes autonomous after years of secondary hyperparathyroidism
In primary hyperparathyroidism, PTH levels are high/low and calcium levels are high/low
In secondary hyperparathyroidism, PTH levels are high/low and calcium levels are high/low
What investigation is done for hyperparathyroidism?
Sestamibi scan - localises adenoma
What is FHH?
Familial hypercalciuric hypercalcaemia
Autosomal dominant disease where CaSR is mutated
List clinical features of hypocalcaemia
What is Chovstek sign in hypocalcaemia?
Tapping over facial nerve produces a twitch of muscle on the ipsilateral side
What is Trousseau sign in hypocalcaemia?
Carpopedal spasm when BP cuff is inflated + held for 3mins
What are the main causes of hypocalcaemia?
Vitamin D deficiency
Chronic renal failure
List causes of hypoparathyroidism
Congenital (DiGeorge syndrome)
What would levels of calcium, phosphate, PTH and ALP be like in hypoparathyroidism?
Which disease(s) are extreme manifestations of vitamin D deficiency?
What would levels of calcium, phosphate, PTH and ALP be like in osteomalacia?
Outline treatment for (chronic) vitamin D deficiency
Vitamin D3 tablets
What is pseudo-hypoparathyroidism?
Resistance to PTH, causing hypocalcaemia (even though PTH may very well be high)
Which gene is defect in pseudo-hypoparathyroidism?
GNAS1 (causing dysfunction of G-protein)
What (the fck) is pseudo-pseudo-hypoparathyroidism?
Phenotypically the individual has pseudo-hypoparathyroidism, but biochemical aspects are normal (i.e. normal calcium)
Outline treatment of hypocalcaemia
IV calcium gluconate (acute)
Vitamin D supplements
What are calcium, PTH, ALP and phosphate levels like in hyperparathyroidism?
What are calcium, PTH, ALP and phosphate levels like in bone malignancy?
What are calcium, PTH, ALP and phosphate levels like in FHH?