Flashcards in Disorders of Ca and PT gland Deck (20):
Where are CaSR found?
PT, kidney, C cells, bone
Causes for hypercalcemia
#MISHAP (malignancy, intox of VD, sarcoidosis, hyperpara, alkali, pagets
Also Familial hypocalciuric hypercalcemia or meds induced (lithium or HCTZ)
Etiology of primary hyperparathyroidism
15% hyperplasia (MEN1, MEN2A)
Epidemiology of hyperparathyroidism
Pt with hypercalcemia have what symptoms?#
stones, bones, groans psychiatric overtones
What happens to hyperparathyroid in post-kidney transplant or end-stage renal disease
Glands become hyperplastic and autonomous
What will PTH be in hypercalcemia due to malignancy and granulomatous disease?
Initial treatment of acute hypercalcemia
address volume status. Calcitonin, bisphosphonates, GC,
What are the major causes of secondary PTH elevation?
Hypocalcemia, hyperphosphatemia, VD deficiency
What happens to VD in renal disease?
decrease 1a hydroxylase- decreased active VD
____% of pt with osteoporosis have VD deficiency
Clinical signs of hypocalcemia
trousseaus, chvosteks, hyperreflexia, agitation, convulsions, hypertension, long QT
What are causes of primary hypoparathyroidism?
post-thyroidectomy, idiopathic, autoimmune, agenesis (DiGeroge), hypomagnesaemia, hypermag, hyperphosph
Miscellaneous causes of hypocalcemia
acute pancreatitis, massive transfusion, tumor lysis, severe sepsis, meds, hungry bone syndrome
What is the clinical manifestation of pseudohypoparathyroidism?
elevated PTH, hypocalcemia, hyperphosphatemia, short stature, round face, knuckle knuckle dimple dimple (esp 4th), obesity, Albright's hereditary osteodystrophy
What is the molecular defect for pseudohypoparathyroidism?
inability of PTH to stimulated intracellular events
Should we memorize pseudohypoparathyroidism classifications?
Tx of acute hypocalcemic crisis?
correct mg. Calcium gluconate
Timeline of MEN1 phenotype
Hypercalcemia by age 40. Pituitary tumors between 12 and 38. Insulinomas at 25. Gastrinoma at 35