Case Studies in Pathophysiology – Concept map notes

·         Calcium is the major solute.

·         It plays an important role in stabilizing resting membrane potentials of cells, coagulation, hormone release, and cell signaling.

·         Ninety-nine of calcium is present in bone as calcium phosphate and one percent as skeletal calcium that is freely exchangeable with extracellular fluid.

Pathophysiology

·         Its transmembrane flux plays vital role in hormone secretion and metabolic coordination.

·         Different states of calcium levels results to either hypocalcemia or hypercalcemia.

·         Hypocalcemia is a state of low level of calcium ( total Ca2+ is less than 8.5mg )

·         Hypercalcemia is a state of high-level calcium in blood.

·         Diabetics individuals

·         elderly

·         Cancerous individuals

·         Elderly

·         Hypoparathyroidism in low PTH

·         Vitamin D deficiency

·         Chronic kidney disease

·         Osteoblastic metastases

·         Renal tubular disorders

·         Pseudo hypocalcemia

·         Hungry bone syndrome

·         Neonatal hypocalcemia

·         Multiple blood transfusions and hemolysis

·         Overactive parathyroid glands

·         Excess vitamin D

·         Cancer such as lung cancer, breast cancer and blood cancers.

·         Dehydration

·         Reduced mobility

·         Low PTH- congenial disorders of parathyroid glands

and autoimmune destruction of parathyroid glands.

·         High PTH- decreased enzymatic hydroxylation to active form,

malabsorption, decreased renal excretion of phosphate

thus decreasing Calcium ions, calcium precipitation in

the abdomen, and increased phosphate intake.

·         PTH-mediated – excess PTH increases active vitamin D production via stimulation of 1-alpha-hydroxylase synthesis in kidneys.

·         Renal failure that results to chronic secondary hyperparathyroidism leading to autonomous activation of parathyroid glands.

·         Non-PTH-mediated – hydroxylase activity in activated mononuclear cells produces 1, 25 –dihydroxyvitamin D outside kidneys.

·         muscle spasms such as carpopedal spams

·         Induced tetany when caused by respiratory

·         Alkalosis

·         Seizures

·         Cardiac ventricular arrhythmias

·         Hypotension

·         Myocardial depression

·         Biliary colic

·         Diarrhea and abdominal cramping

·         Bone pain

·         Abdominal pain

·         Nausea and vomiting

·         Anorexia

·         Peptic ulcer disease

·         Pancreatitis

·         Polyuria and dehydration

·         Diminished muscle excitability

·         Hypercalcemic crisis

·         Serum calcium concentration test

·         Parathyroid hormone blood test

·         Electrocardiography test

·         Urine tests

·         Electrocardiography test

·         Treat any underlying conditions such as hypoparathyroidism, Loop diuretics or hypomagnesemia.

·         Calcium supplementation

–          oral calcium for mild neuromuscular Patients

–          IV calcium for symptomatic patients

·         Treatment of underlying disorders such as glucocorticoids

·         Reduction of calcium intake in diets of asymptomatic hypercalcemia.

·         IV hydration with isotonic saline in symptomatic patients.

·         Cause based therapy.

·         Neurologic complications such as tetany or acute seizures,

·         Parkinsonism, hemiballismus, choreoathetosis, and

·         Basal ganglia calcification.

·         Laryngospasm

·         Cardiac arrhythmias

·         Osteoporosis

·         Kidney stones

·         Kidney failure

·         Nervous system complications such as dementia, tiredness, weakness, and confusion.

·         Irregular heartbeat