Calcium Disorders Flashcards Preview

2MB Endocrinology > Calcium Disorders > Flashcards

Flashcards in Calcium Disorders Deck (26)
Loading flashcards...
1

List clinical features of hypercalcaemia

Thirst, dehydration
Confusion
Polyuria
Myopathy
Osteopenia, fractures
Hypertension
Abdo pain (renal stones, pancreatitis)

2

List the main causes of hypercalcaemia

Hyperparathyroidism
Malignancy
Drugs (vit D, thiazides)
TB, sarcoidosis
High cell turnover (Paget's)
FHH

3

If you could do one test to investigate hypercalcaemia, what would you do?

Measure PTH levels

4

Outline management of hypercalcaemia

Fluid replacement
Loop diuretic
Biphosphonate

5

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

6

In primary hyperparathyroidism, PTH levels are high/low and calcium levels are high/low

PTH high
Calcium high

7

In secondary hyperparathyroidism, PTH levels are high/low and calcium levels are high/low

PTH high
Calcium low

8

What investigation is done for hyperparathyroidism?

Sestamibi scan - localises adenoma

9

What is FHH?

Familial hypercalciuric hypercalcaemia
Autosomal dominant disease where CaSR is mutated

10

List clinical features of hypocalcaemia

Paraesthesia
Muscle cramps/tetany/weakness
Fatigue
Bronchospasm
Chovstek sign
Trousseau sign

11

What is Chovstek sign in hypocalcaemia?

Tapping over facial nerve produces a twitch of muscle on the ipsilateral side

12

What is Trousseau sign in hypocalcaemia?

Carpopedal spasm when BP cuff is inflated + held for 3mins

13

What are the main causes of hypocalcaemia?

Hypoparathyroidism
Vitamin D deficiency
Chronic renal failure

14

List causes of hypoparathyroidism

Congenital (DiGeorge syndrome)
Trauma/iatrogenic
Autoimmunity
Low magnesium

15

What would levels of calcium, phosphate, PTH and ALP be like in hypoparathyroidism?

Calcium low
Phosphate high
PTH low
ALP normal

16

Which disease(s) are extreme manifestations of vitamin D deficiency?

Osteomalacia (adults)
Rickets (children)

17

What would levels of calcium, phosphate, PTH and ALP be like in osteomalacia?

Calcium normal/low
Phosphate low
PTH normal
ALP high

18

Outline treatment for (chronic) vitamin D deficiency

Vitamin D3 tablets
Calcitriol
Alfacalcidol

19

What is pseudo-hypoparathyroidism?

Resistance to PTH, causing hypocalcaemia (even though PTH may very well be high)

20

Which gene is defect in pseudo-hypoparathyroidism?

GNAS1 (causing dysfunction of G-protein)

21

What (the fck) is pseudo-pseudo-hypoparathyroidism?

Phenotypically the individual has pseudo-hypoparathyroidism, but biochemical aspects are normal (i.e. normal calcium)

22

Outline treatment of hypocalcaemia

IV calcium gluconate (acute)
Calcium supplements
Vitamin D supplements

23

What are calcium, PTH, ALP and phosphate levels like in hyperparathyroidism?

Calcium high
PTH high
ALP normal/high
Phosphate normal

24

What are calcium, PTH, ALP and phosphate levels like in bone malignancy?

Calcium high
PTH low
ALP high
Phosphate normal

25

What are calcium, PTH, ALP and phosphate levels like in FHH?

Calcium high
PTH normal/high
ALP normal
Phosphate high

26

What are calcium, PTH, ALP and phosphate levels like in hypoparathyroidism?

Calcium low
PTH low
ALP normal
Phosphate normal/high