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hyper and hypocalcemia
Terms in this set (17)
usualyl caused by a single parathyroid gland adenoma
may be associated with MEN
physiological compensatory hypertrophy of the glands in response to prolonged hypocalcemia (in chronic kidney disease,or vitamin D def).
parathyroid hyperplasia after longstanding secondary hyperparathyroidism,most often in renal disease.
Plamsa calcium and PTH are both raised.
causes of hypercalcemia
excess action of vitamin d
excess vitamin D
other endocrine diseases
ectopic pth :rare
secondary depositis in bone
other endocrine disease causing hypercalcemia
drugs causung hypercalcemia
severe: general malaise, depression,bone pain,abdnomian pain,constipation,nocturia
renal calculi,chronic kidney disease may develop.
with very high levels of calcium
clouding of concioussness
risk of cardaic arrest
serum calcium and phosphate
24 h urinary calcium
hydrocortisone supression test
management of hypercalcemia
rehydration with iv saline
treatment pf primary hyperparathyroidism
increase serum phosphate levels: ckd
CHRONIC KIDNEY DISEASE: results from inadequate production of active vitamin D and renal phosphate retention!
reduced PTH function : congenital def.
vitamin D def
drugs : calcitonin,bisphosphonate
cf of hypocalcemia
increases the excitability of muscles and nerve!!!!
followed by cramps ,tetany
convuslions and death if untreated
prolonged QT interval of ECG
signs of hypocalcemia
tests for neuromuscular excitability.
managment of hypocalcemia
acute : calcium gluconate iv. with ecg monitoring.
persisten hypocalcemia: in vit.d def: cholecalciferol.
if hypoparathyroidism : this trt is ineffetive,cause PTH is needed for conversion to active form of vitamin d.
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