Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
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.
|
