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Diagnosis of Hypercalcemia and Knowledge Check

by Carlo Raj, MD
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    Let’s take a look at what happens here and I want you to identify some of these patients. I’m just going to walk you through a couple. We’ll take a look at primary and secondary hypoparathyroidism and that is it. Would you please identify, for me, primary hypoparathyroidism? Okay, on your X-axis, we find calcium and on your Y-axis, we find PTH. If you have primary hypoparathyroidism, where’s my problem? In the parathyroids. And you might have a solitary adenoma, it’s majority of the time will be a solitary adenoma in which it is primarily releasing PTH. Next, with all that PTH being elevated, what then happens to your calcium levels? It is also elevated. So, which letter here only gives you that exact figure? Let’s take a look at A. A gives you decreased calcium and it gives you high PTH. Is that a possibility in primary hypoparathyroidism? I-I am asking you to please identify primary hypoparathyroidism. That is not possible with patient A. Patient A with a low calcium may then cause secondary hypoparathyroidism, so we’ve identified that patient. Most common cause, renal failure. Patient B… Patient B, you find there to be elevated levels of PTH and you also find elevated levels of calcium. That’s your patient, ladies and gentlemen, of primary hypoparathyroidism; Patient A secondary hypoparathyroidism. You go as far as that, you will be in good shape. In this table, we’ll take a look at various diagnosis of hypercalcemia begin by PTH being very high. We have primary hyperparathyroidism that we talked about with the solitary nodule, commonly seen with MEN 1 with your pan-pancreas; para-hypoparathyroidism; pit-pituitary, parathyroid-hypoparathyroidism primary. 2a would be primary hypoparathyroidism; major cancer of the thyroid and pheochromocytoma, if you remember correctly. Hypercalcemia, the PTH levels might be normal or slightly high....

    About the Lecture

    The lecture Diagnosis of Hypercalcemia and Knowledge Check by Carlo Raj, MD is from the course Parathyroid Gland Disorders.


    Included Quiz Questions

    1. High PTH, high calcium, normal to low phosphate
    2. High PTH, high calcium, high phosphate
    3. High PTH, low calcium, normal to high phosphate
    4. Low PTH, high calcium, low phosphate
    5. Low PTH, low calcium, low phosphate
    1. FHH
    2. Primary hyperparathyroidism
    3. MEN 2a
    4. Lithium overdose
    5. Vitamin D intoxication
    1. Increased PTHrP
    2. Increased PTH
    3. Decreased calcium
    4. Increased vitamin D
    5. Urine calcium <100mg/day

    Author of lecture Diagnosis of Hypercalcemia and Knowledge Check

     Carlo Raj, MD

    Carlo Raj, MD


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