A video tutorial on fluid balance. This tutorial includes basic biochemistry and physiology of electrolytes followed by an outline of clinical conditions such as hypovolaemia, hypervolaemia, hypocalcaemia, hypercalcaemia and syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH).
over 10 years ago
Osteomalacia is the softening of the bones caused by deactivated bone mineralization primary to adequate levels of available phosphate and calcium, or because of over weight body resorption of calcium from the intestine of the body which can be caused by hyperparathyroidism (which causes hypercalcemia). Osteomalacia in children is known as rickets, and because of this, use of the term "osteomalacia" is often restricted to the milder, adult form of the disease. Signs and symptoms can include diffuse body pains, muscle weakness, and fragility of the bones.
almost 8 years ago
I was discussing with a renal consultant the reasons for avoiding thiazides in patients with sarcoidosis with renal involvement. I think it is well established that they can cause hypercalcaemia but after (not very much) searching on the internet and in textbooks I can't seem to find out why? Does anybody know?
over 8 years ago
Hypercalcemia is a disorder commonly encountered by primary care physicians. The diagnosis often is made incidentally in asymptomatic patients. Clinical manifestations affect the neuromuscular, gastrointestinal, renal, skeletal, and cardiovascular systems. The most common causes of hypercalcemia are primary hyperparathyroidism and malignancy. Some other important causes of hypercalcemia are medications and familial hypocalciuric hypercalcemia. An initial diagnostic work-up should include measurement of intact parathyroid hormone, and any medications that are likely to be causative should be discontinued. Parathyroid hormone is suppressed in malignancy-associated hypercalcemia and elevated in primary hyperparathyroidism. It is essential to exclude other causes before considering parathyroid surgery, and patients should be referred for parathyroidectomy only if they meet certain criteria. Many patients with primary hyperparathyroidism have a benign course and do not need surgery. Hypercalcemic crisis is a life-threatening emergency. Aggressive intravenous rehydration is the mainstay of management in severe hypercalcemia, and antiresorptive agents, such as calcitonin and bisphosphonates, frequently can alleviate the clinical manifestations of hypercalcemic disorders.
about 7 years ago
The following AP thoracolumbar x-ray is from a 65 year old who has presented to the ED with severe thoracic pain. He is noted to have acute renal failure and hypercalcaemia on blood tests. What subtle finding can be seen?
almost 7 years ago
The thoracic spine x-ray shows destruction of the left pedicle of the T8 vertebra by a lytic process (winking owl sign). In the context of acute renal failure and hypercalcaemia, this is likely to be a myeloma deposit. Myeloma was confirmed on further tests.
almost 7 years ago