Hypercalcemia secondary to Primary Hyperparathyroidism. Emily Kingsley, MD Med-Peds II. 90% of cases of hypercalcemia are due to hyperparathyroidism and malignancy
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Hypercalcemia secondary to Primary Hyperparathyroidism
Emily Kingsley, MD
Peptic ulcer disease
Profound muscle weakness
Shortening of the QT interval
Polyuria: decr. concentration in distal tub.
Acute/Chronic renal insuffic.
Serum calcium of 12 to 15 mg/dL can lead to a reversible fall in GFR from direct renal vasoconstriction
Long-standing hypercalcemia and hypercalciuria: Calcification, degeneration, and necrosis of the tubular cells →Tubular atrophy and interstitial fibrosis and calcification (nephrocalcinosis).
Ca = Serum Ca + 0.8 * (Normal Albumin – Pt Albumin)
Vitamin D levels
Vitamin A levels
Vit D intoxication
Haden, ST, Brown, EM, Hurwitz, S, et al. The effects of age and gender on parathyroid hormone dynamics. Clin Endocrinol 2000; 52:329.
Granulomatous dis. Milk Alkali Syndrome
Vitamin D intoxication Metastatic bone dis.
-Inhibition of renal proximal tubular
Treats volume depletion from calcium-induced urinary salt wasting
Increases renal perfusion and urinary calcium clearance
Administration: Initial rate of 200-300ml/hr adjusted for urinary output of 100ml/h
Limited in those with cardiac or renal disease
Should be discontinued with development of edema
Rarely normalizes calcium level
(What would a Med-Peds presentation
be without a Sponge Bob reference?!?!)