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34 terms

Hypercalcemia and Hypocalcemia

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Where is most of the calcium stored in the body?
bones
What is the primary control of intestinal calcium absorption?
Vitamin D
What effect do glucocorticoids have on absorption of calcium?
decrease
Renally, calcium is reabsorbed via co-transport in the ascending limb with what ion?
Chlorine
PTH increases reabsorption of calcium in what part of the nephron?
distal convoluted tubule
Vitamin D is transformed into it's active form in what organ?
kidneys
Would a dog with osteopenia neccesarily have a low serum calcium?
no
Is the calcium in the bones quickly mobilized?
no
What are the three forms that serum calcium can take?
Ionized Calcium
Protein Bound Calcium
Complexed Calcium
What are three compounds that calcium complexes with?
phosphate
citrate
bicarbonate
What form of serum calcium is active?
ionized
Would a dog with low total calcium always have clinical signs of hypocalcemia?
no
How will an increase in pH shift the form of serum calcium?
towards bound
How will an alkaline pH change shift the form of serum calcium?
towards bound
How will a decrease in pH shift the form of serum calcium?
towards ionized
How will an acid pH change shift the form of serum calcium?
towards ionized
How does Hypoalbuminemia affect ionized calcium?
no effect
How does Hypoalbunimia affect total calcium?
reduces
What is the formula to determine calcium levels in the presence of abnormal albumin levels?
Adjusted Ca = Calcium - Albumin + 3.5
How does the normal serum levels of young animals compare with adults?
younger animals have higher normal serum calcium
What are three types of hyperparathyroidism?
Primary hyperparathyroidism
Renal Secondary Hyperparathyroidism
Nutritional Secondary Hyperparathyroidism
Hypercalcemia has what effect at the collecting ducts?
interferes with ADH
Hypercalcemia has what effect at the renal tubules?
nephrocalcinosis
Hypercalcemia has what effect at the glomerulus?
afferent limb vasoconstriction
When I say hypercalcemia, you say...
Lymphosarcoma
What is a less likely neoplasia that may cause hypercalcemia?
Squamous Cell Carcinoma
What are the two main mechanisms for hypercalcemia by malignancy?
bone lysis (via tumor produced cytokines)
PTH-rP production
What are the differential diagnosis for hypercalcmia? (7)
Malignancy
Renal Failure
Primary Hyperparathyroidism
Hypoadrenocorticism
Diffuse bone disease
Granulomatous Disease
Hypervitaminosis D
Is Hypercalcemia secondary to renal failure more common in dogs or cats?
cats
What are the three mechanisms of hypercalcemia secondary to renal failure?
Decreased renal calcium excretion
Increased responsiveness to Vitamin D
Autonomous parathyroid gland secretion
What are the causes of Primary Hyperparathyroidism?
Parathyroid adenoma
Parathyroid adenocarcinoma
Familial hyperparathyroidism
What is the most common cause of primary hyperparathyroidism?
parathyroid adenoma
How do you diagnose primary hyperparathyroidism?
Hypercalcemia/hypophosphatemia
High or normal PTH with hypercalcemia
Ultrasound of the neck
Cervical exploration
What are three causes of Hypervitaminosis D?
Excessive supplementation
Vitamin D containing plants
Vitamin D3 rodenticides