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26 Cards in this Set

  • Front
  • Back
clinical
neuromusc irritability
prolonged QT interval
numbness
cramps
fatigue anxiety
depression
chvostek sign( facial nerve hyperexitability
carpopedal spasm
perioral numbness
mental; irritability
tetanus( trousseau sign)
cataracts
intracranial calcifications
larhyngeal stridor
seizures
etiol
primary hypo parathyroidism
accidental surg tremoval of all glands
auto immune destruction of parathyroids
magnesia deficiency ( required for PTH release and action
pseudo hypoparathyroidism
defect in PTH Rp>>>low ca, high Ph and high PTH
pseudo hypocalcemia
low ca
normal ionized Ca due to low albumin level
ca will be normal when corrected for low albumin 9 add 0.8 mg to serum ca for each 1g of albumin below 4 mg
renal failure - lead to hypoCacemia
kidney convert 25 hydroxy D to more active 1.25 hydroxy D
low ca-

high Ca
twitchy and hyperexitable


lethargic and slow
slip lamp
early catharacts
ds
history and PE
ph - up
ca- down norm renal function
PTH
cAMP level
Disorders of vitamin D metabolism (vitamin D deficiency)
Lack of sunlight
Dermatologic disorders
Dietary deficiency
Malabsorption
Liver disease
Renal disease
Vitamin D–dependent rickets type I (1α-hydroxylase deficiency)
Disorders of vitamin D metabolism (vitamin D deficiency)
Laboratory findings of mild hypocalcemia, hypophosphatemia, elevated PTH level, decreased 25-hydroxy vitamin D level, and decreased 1,25-dihydroxy vitamin D level if renal disease is present. Vitamin D deficiency is widespread among housebound and institutionalized elderly and general medical patients with disorders that predispose to altered vitamin D metabolism.
Vitamin D resistance
Vitamin D–dependent rickets type II
Vitamin D resistance
Laboratory findings of hypocalcemia, hypophosphatemia, elevated PTH level, and elevated 1,25-dihydroxy vitamin D level when treated with vitamin D; vitamin D–receptor defect causes resistance to 1,25-dihydroxy vitamin D3.
Hypoparathyroidism
Postsurgical (thyroid, parathyroid, or neck surgery)
Autoimmune (such as polyglandular autoimmune syndrome)
Congenital (such as DiGeorge syndrome)
Infiltrative (such as hemochromatosis, sarcoidosis)
Hypoparathyroidism
Laboratory findings of hypocalcemia, hyperphosphatemia, and a low or inappropriately normal PTH level; postsurgical hypoparathyroidism is the most common form.
PTH resistance
Pseudohypoparathyroidism
PTH resistance
Pseudohypoparathyroidism

Laboratory findings of hypocalcemia, hyperphosphatemia, and an elevated PTH level with a normal 25-hydroxy vitamin D level; pseudohypoparathyroidism type 1a is an autosomal dominant disorder marked by resistance to multiple hormones and Albright hereditary osteodystrophy (short stature, obesity, round facies, brachymetacarpia, and mental deficiency).
Hypomagnesemia
Laboratory findings of hypocalcemia and low 25-hydroxy vitamin D or 1,25-dihydroxy vitamin D level (with agents that alter vitamin D metabolism); hypocalcemia can develop rapidly with use of some medications, especially if given intravenously
Hypomagnesemia
Those altering vitamin D metabolism (phenytoin, phenobarbital, isoniazid, theophylline, rifampin, 5-fluorouracil plus leucovorin)
Those causing intravascular binding (phosphate, foscarnet, EDTA, citrated blood products)
Bisphosphonates
Extravascular deposition
Pancreatitis
Hungry-bone syndrome
Rhabdomyolysis
Tumor lysis syndrome
Osteoblastic metastase
Extravascular deposition
Laboratory findings of hypocalcemia and hyper-or hypophosphatemia; in pancreatitis, hypocalcemia results from the deposition of calcium in the form of calcium soaps. Hyperphosphatemia suggests rhabdomyolysis or tumor lysis syndrome with release of phosphate from the bone, whereas hypophosphatemia is seen in hungry-bone syndrome or in osteoblastic metastases.
Sepsis
Laboratory findings of hypocalcemia and low PTH and 1,25-dihydroxy vitamin D levels; most likely mediated by the action of inflammatory cytokines on the parathyroid glands, kidneys, and bone.
Acute respiratory alkalosis
Laboratory findings of a normal total serum calcium level but a low ionized calcium level (increased calcium binding to albumin in the serum with resultant reduction in serum ionized calcium level).
Artifactual hypoglycemia with hypoalbuminemia
Laboratory findings of a low total serum calcium level and a normal ionized calcium level (reduced protein binding lowers total serum calcium level but ionized fraction remains normal).
hungry bone
iagnose hungry bone syndrome.
Key Point

* Hungry bone syndrome with severe hypocalcemia and hypophosphatemia can occur after removal of a parathyroid adenoma in patients with significant hyperparathyroid bone disease.

This patient most likely has hungry bone
Pseudo-pseudohypoparathyroidism
Pseudo-pseudohypoparathyroidism refers to the condition in which patients have the phenotypic appearance of pseudohypoparathyroidism but normal calcium and phosphorus levels because of normal PTH secretion, function, and action.
Anxiety-induced hyperventilation can induce a decrease in the ionized calcium level.
Anxiety-induced hyperventilation can induce a decrease in the ionized calcium level. As the partial pressure of carbon dioxide falls, there is a dissociation of hydrogen ions from albumin to compensate for the respiratory alkalosis. This dissociation leads to increased binding of calcium ions to albumin, which causes the ionized calcium level to decrease. This decrease can be sufficient to induce clinical features of hypocalcemia. However, the total calcium level does not decrease, as it has in this patient.