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25 Cards in this Set
- Front
- Back
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what are the causes of hypercalcemia
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pth (hyperpara)
addison's multiple myeloma paget's sarcoidosis Cancer milk alcali D (vit OD) thiazides |
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Low serum Ca feedback
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decrease in Ca triggers PTH secretion via CaSR on parathyroid cells.
PTH inc tubular reabsorption of Ca in kidneys PTH inc resorption of from bone PTH stimulates renal 1,25(OH)2 D prod. 1,25 acts on intestine to increase Ca absorption |
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what is the normal level of Ca
mild hypercalcemia severe |
8.4-10.2
11-11.5 12-13 *(short QT) |
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What is chronic hyperCa MCC by
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hyperparathyroidisim
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2 MCC hyperCa
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malignancy
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How do granulomatous disorders (sarcoidosis) cause hyperCa
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increased 1,25 OH2 D
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initial treatment of hypercalcemia
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volume expansion, hyperCa leads to dehydration (4-6 L IV saline first 24h
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In patients with 1,25 OH2 d mediated hyperCa, what is the preferred therapy
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glucocorticoids
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effect of keto, chloroquine, hydroxycloroquine on 1,25 oh2d
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decreases
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classification of hypoCa
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low PTH (hypopara)
high PTH (2ary hyperpara) |
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what are the 2 MCC of hypocalcemia
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impaired pth, impaired vit D
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MCC of hypopara in adults
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damage to glands during thy surgery
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how does sarcoidosis play a role in hypoparathyroidism
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rarely infiltrates
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causes of hypocalcemia
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vit d deficiency, impaired 1,25 (due to renal insuff), severe tissue injury
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Ss of hypocalcemia
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paresthesia (increased NM irritability)
chvostek, Trousseau, seizure, broncho, laryngospasm, prolong of qt |
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What labs do you look for
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serum calcium
albumin phosphorus magnesium |
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Acute Hypocalcemia tx
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calcium gluconate
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Chronic Hypocalcemia tx
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Ca supplements, Vit D3, Calcitrol (1,25)
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Resistance to PTH
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Pseudohypoparathyroidism
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How are the labs of a pt with pseudohypopara
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low Ca
high P high PTH |
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where is the dysfunction in a pt with pseudohypopara
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Gs alpha subunit
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which is pseudohypopara type Ia
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albright's hereditary osteodystrophy
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what are the signs of type Ia
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short stature, obesity, round fascies, short 4th 5th metatarsals, mental retardation
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what is the name of the sign of the shortened 4th and 5th metatarsals in pseudohypoparathyroidism type Ia
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Archibald's sign
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how is albright's hereditary osteo. inherited
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AD
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