Calcium Homeostasis and Disorders Flashcards Preview

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Flashcards in Calcium Homeostasis and Disorders Deck (34):
1

how does PTH increase serium calcium?

absorption from gut

resorption from bone

2

where can you get Vit D from?

sun and diet

3

what does acute hypercalcaemia present with?

thirst
dehydration
confusion
poluria

4

what does chronic hypercalcaemia present like?

myoptahy
osteopaenia, fractures
depression
hypertension
abdo pain- pancreatitis uclers, renal stones

5

moans, groans, bones, stones

(depression, constipation, sore bones, renal stones)

hypercalcaemia

6

if suspected hypercalcaemia what should you test?

PTH

7

if high Ca and high Alk Phos

sarcoidosis
thrytoxicosis
bone metas

8

if high Ca and low Alk Phos

myeloma
Vit D excess
mild alkali syndrome

9

main 2 causes of hypercalcaemia?

primary hyperparathyroidism

maligancy

10

how do you diagnose primary hyperparathyroidism

increased serum calcium
increase serum PTH
increase calcium in urine

11

how do you treat acute hypercalcaemia?

fluids-rehydrate with saline
consider loop diuretics once rehydrated

bisphosphonates
steroids- e.d 40-60mg prednislone for sarcoidosis

12

management for primary hyperparathyroidism?

surgery or nothing

13

indications for surgery for primary hyperparathyroidism?

bone disease
gastric ulcers
renal stones
osteoporosis

eGFR

14

chovsteks sign (tapping over facial nerve)
Trousseau sign (carpopedal spasm)

hypocalcaemia

15

paraesthesia- fingers and toes
muscle cramps
muscle weakness
fatigue
bronchospasm
fits
QT prolongation

hypocalcaemia

16

causes of hypocalcaemia

hypoparathyroidism
vit D deficiency
chronic renal failure
hyperventiliation
pancreatits

17

causes of hypoparathyroidism?

congenital
autoimmune
destruction
idiopathic

18

how do you treat acute hypoglycaemia?

IV calcium gluconate

19

long term management of hypoglycaemia?

calcium supplements
Vit D- tablets or injection

20

what is calcium release from cells dependent on?

magnesium

21

what can cause hypomagnasemia?

alcohol
thiazides
PPIs
GI illness
pancreatitis
malabsorption

22

genetic defect in GNAS 1 gene
low calcium but high PTH

bony abnormalities
obesity
subcutaneous calcification
learning disability
brachdactyly (4th metacarpal)

Pseudohypoparathyroidism

23

what is pseudo-pseudohypoparathyroidism

same as pseudohypoparathyroidism but normal calcium level

24

what is rickets and osteomalacia

vit D deficiency

25

what can cause Vit D deficiency?

lack in diet
lack of sunlight
chronic liver failure
malabsorption-coeliac
drugs-anticonvulsants

26

what is osteopenia?

low bone mass

27

how do you assess bone density?

DEXA scans

28

what lifestyle management advice should you give for someone with osteoporosis?

high intensity strength training
low impact weight bearing exerrcise
avoid excess alcohol
avoid smoking
fall prevention
try to get more calcium from diet

29

what are alendronate and risedronate?

bisphosphonates

30

how long should you take bisphosphonates for?

5 years cause can cause osteonecrosis of jaw

31

what is Densumab?

a monoclonal anitobody for osteoporosis treatment

its an SC injection which can cause cellutlits, eczema and hypocalcaemia

32

drug therapy for osteoporosis?

vit D and calcium supplements
bisphosphonates
Denosumab
Teriparatide
HRT

33

what is Teriparatide?

recombinant parathyroid hormone which stimulates bone growth . once daily injection

34

what is strontium rabelate?

antiresorptive agent