L7: Hypocalcemia Flashcards
(95 cards)
1
Q
Distribution of Ca in the body
A
2
Q
Soluble calcium in the blood
- Derived From
A
3
Q
Soluble calcium in the blood:
- Forms
A
4
Q
Normal serum calcium
A
8.5 - 10.5 mg/dl
5
Q
Normal Ionized calcium
A
4.5 - 5.1 mg/dI
6
Q
Hormonal control of calcium level
A
- Parathyroid Hormone
- Vitamin D
- Calcitonin
7
Q
Fetal development of parathyroid gland
A
8
Q
Characters of Parathyroid hormones
A
9
Q
Regulation of Parathyroid hormones
A
10
Q
Physiology of Parathyroid hormones
A
11
Q
Effects of Parathyroid hormones
A
12
Q
Effects of Parathyroid hormones
- on Bone
A
- calcium mobilization by osteoblast-mediated activation of bone-resorbing osteoclasts.
13
Q
Effects of Parathyroid hormones
- On Kidney
A
14
Q
Effects of Parathyroid hormones
- on GIT
A
- Indirectly increase absorption of Ca and phosphate through vitamin D
15
Q
Nature of Vit D
A
Fat-soluble steroid
16
Q
Types of Vit D
A
17
Q
Synthesis of Vit D
A
18
Q
Effects of Vit D
A
19
Q
Characters of Calcitonin
A
Peptide produced by thyroid parafollicular C celle
20
Q
Regulation of Calcitonin
A
increase in serum Ca —-> Increase in Calcitonin secretion
21
Q
Physiology of Calcitonin
A
Calcitonin acts via protein-coupled receptor
22
Q
Effects of Calcitonin
A
23
Q
Causes of hypocalcemia
A
24
Q
Etiology of Hypoparathyroidism
A
- Congenital
- Acquired
25
Etiology of **Hypoparathyroidism**
- Congenital
25
Etiology of **Hypoparathyroidism**
- Acquired
26
Etiology of **DiGeorge Syndrome**
27
CP of **DiGeorge Syndrome**
- Cardiac
- Face
- Neck & Mediastinum
- Mentality
28
CP of **DiGeorge Syndrome**
- Cardiac
29
CP of **DiGeorge Syndrome**
- Eyes
30
CP of **DiGeorge Syndrome**
- Nose
31
CP of **DiGeorge Syndrome**
- Ears
32
CP of **DiGeorge Syndrome**
- Mouth
33
CP of **DiGeorge Syndrome**
- Neck & Mediastinum
34
CP of **DiGeorge Syndrome**
- Mentality
35
Def of **PHP**
35
Dx of **PHP**
35
Special Types of **PHP**
Pseudo - hypoparathyroidism type 1A (PHPIA) (Albright hereditary osteodystrophy)
36
CP of **Type 1A (PHPIA) (Albright hereditary osteodystrophy)**
- Hand
- MSK
- Mentality
- Head
37
CP of **Type 1A (PHPIA) (Albright hereditary osteodystrophy)**
- Hand
38
CP of **Type 1A (PHPIA) (Albright hereditary osteodystrophy)**
- MSK
- Short stature
- Subcutaneous ossifications
39
CP of **Type 1A (PHPIA) (Albright hereditary osteodystrophy)**
- Mentality
Mild or moderate mental retardation
40
CP of **Type 1A (PHPIA) (Albright hereditary osteodystrophy)**
- Hand
- Round face
- Dental defects
- Sensory-neural abnormalities
41
PPHP
42
Etiology of **Vit D Deficiency**
- Decreased Intake
- Decreased absorbtion
- Decreased Production
- Increased Excretion
43
Etiology of **Vit D Deficiency**
- Nutritional
44
Etiology of **Vit D Deficiency**
- Absorbtion
45
Etiology of **Vit D Deficiency**
- 25-Hydroxyvitamin D Related Causes
46
Etiology of **Vit D Deficiency**
- 1,25 - Dihydroxyvitamin D Related Causes
47
Effects of **Severe Hypomagnesemia**
- Deficient PTH secretion
- Diminished target-cell response.
48
Etiology of **Hypomagnesemia**
- Familial hypomagnesemia
- Malabsorption
- Renal tubular disorders (Bartter, Gitelman, ...)
49
Etiology of **Inorganic Phosphate Excess**
- Increased Intake
- Decreased Excretion
- Spurious
- Phosphate Shift
50
Etiology of **Inorganic Phosphate Excess**
- Increased Intake
- Poisoning
- Oral or parenteral excess administration
- Milk-alkali syndrome
- Vitamin D intoxication
51
Etiology of **Inorganic Phosphate Excess**
- Decreased Excretion
- Renal failure (acute or chronic)
- Hypoparathyroidism
- Severe hypomagnesemia
- Bisphosphonate therapy
52
Etiology of **Inorganic Phosphate Excess**
- Spurious
Pseudo - hyperphosphatemia:
- Blood sample taken from line containing heparin
- In vitro hemolysis
- Hyperbilirubinemia
- Hyperlipidemia
53
Etiology of **Inorganic Phosphate Excess**
- Potassium Shift
* Rhabdomyolysis
* Tumor lysis syndrome
* Acute hemolysis
* Acute metabolic or respiratory acidosis
54
CP of **Hypocalcemia**
55
CP of **Hypocalcemia**
- NMJ
- Tetany
- Permanent mental deterioration (longstanding, not-treated)
56
CP of **Hypocalcemia**
- Head
57
CP of **Hypocalcemia**
- Autoimmune
58
CP of **Hypocalcemia**
- MSK
* Horizontal lines over the nails
* Permanent physical deterioration (longstanding, not-treated)
59
Def of **Tetany**
- State of hyperexcitability of the neuromuscular system due to decreased ionized calcium in the blood
60
Types of **Tetany**
61
Relation between pH & Tetany
62
CP of **Tetany**
63
CP of **Latent Tetany**
64
CP of **Latent Tetany**
- Chovstek sign
Tapping of facial nerve in front of the ear lead to spasm of facial muscles of same side
65
CP of **Latent Tetany**
- Trousseau Sign
- Compress upper arm with sphygmomanometer cuff with sphygmomanometer cuff with pressure between systolic and diastolic lead to carpal spasm
66
CP of **Latent Tetany**
- Erb's Sign
Low galvanic current (<5mAm) lead to muscle contraction
67
CP of **Latent Tetany**
- Peroneal Sign
Tap peroneal nerve near head of fibula lead to pedal spasm
68
CP of **Manifest Tetany**
69
CP of **Manifest Tetany**
- Carpal Spasm
70
CP of **Manifest Tetany**
- Pedal Spasm
Foot extended in position of talipes equinus position with flexion of toes
71
CP of **Manifest Tetany**
- Laryngeal Spasm
Attacks of spasmodic closure of the larynx (stridor)
72
CP of **Manifest Tetany**
- Convulsions
With loss of consciousness
73
INVx for **Hypocalcemia**
- Labs
- Rads
- EP
74
INVx for **Hypocalcemia**
- Labs
75
INVx for **Hypocalcemia**
- Confirmation
Total & ionized Ca
76
INVx for **Hypocalcemia**
- Other Abnormalities
- Renal function and creatinine clearance
- Serum phosphate & Mg
77
INVx for **Hypocalcemia**
- PTH
78
INVx for **Hypocalcemia**
- Other Studies
79
Hypocalcemia & Addison's Disease
80
INVx for **Hypocalcemia**
- Rads
81
INVx for **Hypocalcemia**
- ECG & EEG
82
Lab INVx for different causes of hypocalcemia
83
TTT of **Hypocalcemia**
- Emergency
- Maintainence
84
TTT of **Hypocalcemia**
- Emergency TTT
85
Emergency TTT of **Hypocalcemia**
- Calcium Gluconate
86
Emergency TTT of **Hypocalcemia**
- Calcitriol (1,25 OH D3)
87
Manintenance TTT of **Hypocalcemia**
88
Manintenance TTT of **Hypocalcemia**
- Avoid food rich in PO4
89
Manintenance TTT of **Hypocalcemia**
- Vit D
90
Manintenance TTT of **Hypocalcemia**
- Calcium
91
Different Oral Ca Salts
92
Alpha Calcidol Perparations (One Alpha)
