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Module 11

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  1. Module 11 Rebecca Moriero Polydipsia and Hypercalcemia

  2. Polydipsia Poly - Suffix meaning many-Dipsia – Prefix meaning Thirst • Polydipsia is the medical term that is given to the abnormal increase in thirst and can lead the patient to drink large quantities of fluid, usually water. It is also frequently accompanied by temporary or prolonged dryness of the mouth • Thirst is a normal process the body uses to maintain adequate fluid levels. • Excessive thirst however could be a sign of more serious conditions.

  3. PolydipsiaCauses Causes for temporary polydipsia include: • Exercise • Spicy Food • Salty Food • Diarrhea • Vomiting • Profuse sweating • Significant blood loss or • Certain prescription medications

  4. PolydipsiaCauses Causes of Persistent Polydipsia: • Diabetes mellitus • Diabetes insipidus - a rare condition that occurs when the kidneys are unable to conserve water. This condition is unrelated to diabetes mellitus. • Dehydration • Loss of body fluids from the bloodstream tissues due to: burns or severe infections (sepsis) or heart, liver, or kidney failure • Psychogenic polydipsia – a mental/psychiatric disorder associated with compulsive water drinking

  5. POLYDIPSIASymptoms of Polydipsia • Having persistent and unexplained thirst, regardless of how much the patient drinks • Passing more than 5 liters of urine a day • If the patient has diabetes and experiences increased thirst for a number of days, they should make an appointment to see a doctor. • If the patient does not have diabetes, they should see a doctor if the reason for thirst cannot be explained and especially if they have other symptoms of diabetes, in especially polyuria (excessive amounts of Urine) and polyphagia (Excessive hunger).

  6. HYPERCALCEMIA Hyper - Suffix meaning excessiveCalc/o- Combining Form meaning Calcium-emia– Prefix meaning blood condition • Hypercalcemia is the medical term that is given when there is too much calcium in the blood. • Calcium is needed for body functions such as: • Bone formation • Hormone release • Muscle contraction • Nerve and brain function "metastatic calcification" in the lung of a patient with a very high serum calcium level (hypercalcemia)

  7. HYPERCALCEMIA Who is at Risk • Hypercalcemia affects less than 1% of the population because we have the ability to measure blood calcium since the 1960s and this has improved detection. • Today, the condition is diagnosed at an early stage so most patients with hypercalcemia have no symptoms. • Women over age 50 are most likely to have hypercalcemia, usually due to primary hyperparathyroidism.

  8. HYPERCALCEMIACalcium’s Regulators CA Calcium in the bloodstream Calcium released by the bones CA • PTH (Parathyroid hormone) and vitamin D help to manage calcium balance in the body. PTH is secreted by the parathyroid glands. • These glands are located in the neck behind the thyroid gland. • Vitamin D is obtained from skin exposure to sunlight. • Vitamin D is also obtained from dietary sources. If Calcium levels are low, more PTH is released to signal bones to release more calcium CA CA CA PTH PTH PTH CA If Calcium levels are too high, less PTH is released and the bones will release less calcium CA CA CA PTH PTH PTH CA CA CA

  9. HYPERCALCEMIACauses Thyroid Gland Parathyroid Glands Secrete excess PTH • Primary hyperparathyroidism is the most common cause of Hypercalcemia because of excess PTH secretion by the parathyroid glands. • Other medical conditions can also cause hypercalcemia: • Adrenal gland failure • familial hypocalciuric hypercalcemia An inherited condition • Being bedbound (or not being able to move) for a long period of time • milk-alkali syndrome, calcium excess in the diet • Hyperthyroidism • Kidney failure • Medications such as lithium and thiazide diuretics (water pills) • Some cancerous tumors • Vitamin D excess (hypervitaminosis D) from diet or inflammatory diseases

  10. HYPERCALCEMIASymptoms Kidney symptoms: • Flank pain • Frequent thirst • Frequent urination Muscle symptoms: • Muscle twitches • Weakness Psychological symptoms: • Apathy • Dementia • Depression • Irritability • Memory loss Skeletal symptoms: • Bone pain • Bowing of the shoulders • Fractures due to disease (pathological fractures) • Loss of height • Spinal column curvature

  11. HYPERCALCEMIADiagnosis Exams and Tests that can detect the condition: • Serum calcium • Serum PTH • Serum PTHrP (PTH-related protein) • Serum vitamin D level • Urine calcium

  12. HYPERCALCEMIA Treatment Treatment is aimed at the cause of hypercalcemia whenever possible. surgery may be needed for primary hyperparathyroidism (PHPT) to remove the abnormal parathyroid gland and cure the hypercalcemia. For mild hypercalcemia, monitoring over time may be an option

  13. HYPERCALCEMIA Treatment Severe hypercalcemia that causes symptoms and requires a hospital stay is treated with the following: • Calcitonin • Dialysis • Diuretic medication, such as furosemide • Drugs that stop bone breakdown and absorption by the body, such as pamidronate or etidronate (bisphosphonates) • Fluids through a vein (intravenous fluids) • Glucocorticoids (steroids)

  14. HYPERCALCEMIAComplications Psychological • Depression • Difficulty concentrating or thinking Skeletal • Bone cysts • Fractures • Osteoporosis Gastrointestinal • Pancreatitis • Peptic ulcer disease Kidney • Calcium deposits in the kidney (nephrocalcinosis) • Dehydration • High blood pressure • Kidney failure • Kidney stones Complications of long-term hypercalcemia are uncommon todaybut can include:

  15. HYPERCALCEMIA Prognosis The prognosis depends on the cause of the hypercalcemia. •  Patients with mild hyperparathyroidism or hypercalcemia with a treatable cause have a good prognosis. • Patients with hypercalcemia due to conditions such as cancer or granulomatous disease will have a worse prognosis but this is usually due to the disease itself, rather than the hypercalcemia.

  16. HYPERCALCEMIA Prevention Most causes of hypercalcemia cannot be prevented. However, measures to prevent the condition should be taken by women over 50 and people taking supplements. • Women over age 50 have their blood calcium level checked regularly. • Supplements should be taken in doses that have been consulted with by a health care professional.

  17. Sources • Acute Effects of Sodium Ingestion on Thirst and Cardiovascular Function. US National Library of Medicine National Institutes of Health, 17 May 2010. Web. 22 Mar. 2014. • "Parathyroid Hormone." WebMD. WebMD, n.d. Web. 26 Mar. 2014. • "Polydipsia." - Excessive Thirst Causes and Symptoms. Global Diabetes Community, n.d. Web. 25 Mar. 2014. • "Surgical Pathology -- Hypercalcemia." Surgical Pathology. University of Pittsburgh, n.d. Web. 25 Mar. 2014.

  18. Module 11 Rebecca Moriero Polydipsia and Hypercalcemia