Hypercalcaemia Flashcards Preview

CLP - Endocrinology > Hypercalcaemia > Flashcards

Flashcards in Hypercalcaemia Deck (13):
1

normal serum control

40% is bound to albumin therefore inactive
2.2-2.6 (inc albumin)

2

in acidotic states, is calcium increased or decreased?

increase ionised Ca, by reduced albumin binding

3

in alkalotic states, is calcium increased or decreased?

decrease ionised Ca, by increased albumin binding

4

how is calcium regulated?

diet: gut absorption (vit D)
bones: 99% of Ca
kidneys

5

how is calcium linked to phosphate?

decrease Ca = increase phosphate

6

what hormones are involved in calcium regulation?

PTH (chief cells)
calcitonin (thyroid)
vit D (gut)

7

when is PTH secreted?

PTH is secreted when:
Ca is LOW
vit D is LOW
phosphate is HIGH

8

how does calcitonin regulate Ca?

secreted by parafollicular/C cells of thyroid
acts to decrease Ca by antagonism of effects of PTH on bone
PTH/vit D levels are adjusted in response to calcitonin levels

9

how does PTH regulate Ca?

bone: stimulates Ca REABSORPTION
kidney: renal tubular Ca ABSORPTION
GI: indirectly stimulating GI Ca ABSORPTION by INCREASING vit D activation by the kidney
increases renal phosphate EXCRETION

10

when is vit D secreted?

when Ca is LOW

11

when is calcitonin secreted?

when Ca is HIGH

12

causes

97% primary hyperparathyroidism (high PTH) or malignancy (low PTH)
Renal insufficiency (tertiary hyperPTH)
HyperPTH (primary)
Iatrogenic (AdCal - OP supplement)
Neoplasms
Other endocrinopathies (Addisons)
Sarcoidosis

13

signs and symptoms

Bones: pain, fractures
Stones: renal calculi, polyuria, polydipsia
Groans: high Ca, low gut motility, abdo pain
Psychiatric moans: confusion, headaches, convulsions, coma, death