Acromegaly Assessment
- Excess Growth Hormone (GH)
- Protruding Jaw
- Large Lips and Nose
- Hearing Loss
- Enlargement of Hands and Feet
- Vision Changes and Headache
- Joint Pain
- Peripheral Neuropathy
- Hyperglycemia
Hypocalcemia Causes
- Hypoalbuminemia
- Hypomagnesemia (Less Common Hypermagnesemia)
- Hypovitaminosis D
- Hypoparathyroidism
- Medications
- Hyperphosphatemia
- Malnutrition
- Acute Pancreatitis
- Alkalosis
- Sepsis
- Chronic Kidney Disease
Hypocalcemia
- Muscle Spasms
- < 8.5 mg/dL Ca2+
- Decreased Bone Density
- Tetany
- Chvostek's Sign
- Trousseau's Sign
- Increased DTR
- ECG Changes
- QT Prolongation
- Oral and IV Replacement of Ca2+
- Seizure Precautions
Hypocalcemia Treatments
- Treat Underlying Disorder
- IV Calcium Gluconate
- Cardioprotective
- Calcium Carbonate
- Calcium Citrate
- Vitamin D Supplements
- Treat Hypomagnesemia
Hypercalcemia Causes
- Two CHIMPANZEES Acronym
- Thyroid Disorders
- Calcium Supplements
- Hyperparathyroidism
- Iatrogenic (Drugs, immobility)
- Milk-Alkali Syndrome
- Paget's Disease of Bone
- Acromegaly or Addison's Disease
- Neoplasms
- Zollinger-Ellison Syndrome
- Excessive Vitamin A
- Excessive Vitamin D
- Sarcoidosis
Hypercalcemia
- > 10.5 mg/dL Ca2+
- Pathologic Fractures
- Lethargy
- Hypercoagulation
- Constipation
- ECG Changes
- QT Shortening
- No Calcium Intake
- Chelating Drugs
- Calcitonin
- Bisphosphonates
- Loop Diuretics instead of Thiazide Diuretics
- Increased Risk for Renal Calculi
- Increase Fluids
Hypercalcemia Treatments
- Treat Underlying Disorder
- Hydration
- Dialysis
- Calcium Restriction
- Bisphosphonates
- Calcitonin
- Cinacalcet
- Glucocorticosteroids
- Denosumab
Vitamin D Deficiency
- Rickets in children
- Bending bones
- Rachitic rosary
- Breast milk has decreased vitamin D
- Osteomalacia in adults
- Tetany from Hypocalcemia
Osteoporosis Assessment
- Postmenopausal Women
- Long Term Corticosteroids
- Kyphosis
- Dowager's Hump
- Loss of Height
- Back Pain
- Pathologic Fractures
- Spinal Compression Fracture
Osteoporosis Interventions
- Increased Calcium Intake
- Vitamin D Supplements
- Bisphosphonates
- Raloxifene
- Denosumab
- Calcitonin
- Teriparatide
- Bone Densitometry (DEXA) Scan
- Weight Bearing Exercises
Osteopetrosis (Marble Bone Disease)
- Defective Osteoclast Resorption
- Carbonic Anhydrase II Mutation
- Lack of Acidic Environment
- Fractures
- Nerve Palsies
- Myelophthisic Anemia
- Erlenmeyer Flask Bones
- Normal ALP and PTH
- Normal Calcium and Phosphorus
- Bone-in-bone Appearance
- Bone Marrow Transplant
Paget's Disease of Bone
- Men > Age 40
- Increased Osteoblast and Osteoclast activity
- Mosaic Pattern
- Increased Skull Diameter
- Hearing Loss
- Fractures
- Bone Ache and Joint Pain
- High Output Heart Failure
- Bone Scan
- Normal Parathyroid hormone (PTH) and Calcium
- Elevated ALP
- Bisphosphonate
- Calcitonin
Renal Osteodystrophy
- Chronic Kidney Disease
- Secondary Hyperparathyroidism
- Hyperphosphatemia
- Hypocalcemia
- Decreased Calcitriol
- Osteitis Fibrosa Cystica
- Osteoporosis
- Osteomalacia
- Treating Underlying Disorder
Pseudohypoparathyroidism Type 1A
- Defect in PTH Receptor
- Increased PTH
- Hypocalcemia and Hyperphosphatemia
- Autosomal Dominant
- Mutation in GNAS Gene
- Maternal Imprinting
- Short Stature
- Shortened 4th Fingers
- Developmental Delay
- Subcutaneous Calcifications
- Tetany
- Seizures
- Calcium and Vitamin D Supplementation