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5 Cards in this Set

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What causes hypercalemia?
Causes of Hypercalcemia (From Most to Least Common)
1. Primary hyperparathyroidism
2. Drug induced: Thaizide diuretics, Vitamin D excess
3. Malignancy: Osteolytic metastasis (breast cancer), PTH-like hormone production (lung cancer); Direct bone invasion (lymphoma)
4. Granulomatous disease (TB, sarcoid)
5. Immobilization
What causes hypocalcemia?
Causes of hypocalcemia

1. Hypoalbuminemia (apparent hypocalcemia)
2. Renal failure
3. Hypoparathyroidism
4. Low magnesium
5. Pancreatitis
6. Multiple blood transfusions (citrate binds calcium)
Apparent hypocalcemia may result for ___________ because most serum calcium is bound to ________ .
Apparent hypocalcemia may result for HYPOALBUMINEMIA because most serum calcium is bound to ALBUMIN.

Total calcium drops by 0.8 mg/dL for every 1 mg/dL fall in albumin.
When should I suspect hypercalcemia?
Hypercalcemia causes nonspecific symptoms or may be discovered inadvertently.

Check calcium in any older patients with confusion, recalcitrant constipation, or polyuria. Other nonspecific signs include include lethargy, nausea, vomiting, anorexia, and abdominal pain (from renal stones, pancreatitis). Severe hypercalcemia causes dehydration by diuresis and/or vomiting.
When should I suspect hypocalcemia?
Severa or rapidly acquired hypocalcemia causes painful tetany (muscle spasms).

Classic findings are Trousseau's sign (carpal spasm with blood pressure cuff inflated just above systolic pressure) and Chvostek's sign (facial twitching elicited by tapping just anterior to the ear). Lethargy, confusion, or seizures may also occur.