Tiêu đề ENDOCRINE 1 day.pdf ✅

Causes ● Primary hyperparathyroidism ● Malignancy - Multiple myeloma ● Sarcoidosis ● Hyperthyroidism ● Prolonged immobilization ● Thiazides Hypercalcaemia Mnemonic Symptoms Bones Painful bones especially seen in primary hyperparathyroidism Stones Renal stones Groans ● Constipation ● Pancreatitis ● Vomiting ● Nausea Psychiatric moans ● Lethargy ● Easy fatigue ● Depression
High P T H L E V E L Low CALCIUM LEVEL High PTH independent hypercalcaemia ● ↑ intake of calcium and Vit D ● Malignancy 1° Hypoparathyroidism ● Surgical resection of parathyroid gland ● Autoimmune condition 1° Hyperparathyroidism ● Hyperplasia ● Adenoma ● Carcinoma 2° Hyperparathyroidism ● Vit D deficiency ● ↓ Calcium intake ● Chronic renal failure ● Vit D resistant rickets Treatment ● Immediate: 0.9% NS to increase urinary excretion of calcium ● Loop diuretic: Furosemide to increase calcium excretion ● Bisphosphonates: Zoledronic acid to reduce bone resorption ● Denosumab to reduce bone resorption Hypercalcaemia
Causes ● Low PTH: ○ Parathyroid destruction by surgery, metastases or amyloidosis ○ Autoimmune ● High PTH: ○ Vit D deficiency ○ PTH resistance - Pseudohypoparathyroidism ● Hyperventilation ● Acute pancreatitis Symptoms “CATs go numb” ● Convulsions ● Arrhythmia ● Tetany and carpopedal spasm ● Paraesthesia (perioral, fingers and toes) Hypocalcaemia