Endocrine - Calcium disorders Flashcards Preview

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Flashcards in Endocrine - Calcium disorders Deck (13):
0

Most common cause of Asymptomatic hypercalcemia?

If patient presents with severe, acute symptomatic hypercalcemia, consider?

Primary hyperparathyroidism

Malignancy releasing PTrH

1

Causes of Hypercalcemia?

#Vitamin D intoxication (milk alkali)
#Sarcoidosis
#Thiazide diuretics
#Hyperthyroidism
#Multiple myeloma or metastatic disease

2

Presentation of hypercalcemia?

#Neuro – confusion, stupor, lethargy
#Cardio – short QT and hypertension
#G.I. – SBO-like (constipation, anorexia, nausea/vomiting, Abdominal pain) and Peptic ulcer disease
#Bone – osteoporosis
#Renal – nephrolithiasis, diabetes insipidus, renal insufficiency

3

Treatment for acute hypercalcemia?

If Patient continues to be hypercalcemic?

If patient is in renal failure?

#Saline hydration
#Bisphosphonates

Calcitonin

Dialysis

4

Causes of primary hyperparathyroidism?

#Solitary adenoma
#Hyperplasia
#Malignancy

5

Primary hyperparathyroidism presentations?

Usually asymptomatic, long-term manifestations include

#osteoporosis
#nephrolithiasis and renal insufficiency
#Muscle weakness
#Anorexia, nausea/vomiting, Abdominal pain
#Peptic ulcer disease

6

Why does hyperparathyroidism cause peptic ulcer disease?

Calcium stimulates gastrin

7

Diagnostic tests to suggest hyperparathyroidism?

#High calcium and PTH
#Low phosphate
#High chloride
#High BUN/creatinine

EKG with short QT

8

Treatment of hyperparathyroidism? If not an option?

Surgical removal

Cinecalcet

9

Primary Hypoparathyroidism is most often due to? Other causes of hypoparathyroidism include?

#Prior neck surgery (thyroidectomy)

#hypoMg (Less PTH release and urine loss of Ca)
#renal failure (no active vitamin D)
#Vitamin D deficiency
#Fat malabsorption
#Low albumin

10

For every point decreased in albumin, effect on Ca? Why no symptoms?

Drops by 0.8; free calcium level is normal

11

Presentation of hypocalcemia?

#Chovstek's sign
#Carpopedal spasm
#Perioral numbness
#Seizures
#Tetany (Trousseau sign)

12

Diagnostic tests that suggests hypocalcemia?

#Prolonged QT
#Cataracts on slit lamp exam

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