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Calcium,
the greatest case report ever told

Joel M. Topf, M.D.
Attending Nephrologist
Cell: 248.470.8163
www.pb\ufb02uids.blogspot.com

Introduction
The perfect case report for calcium

The patient I am using for this chapter on
Calcium and Phosphorous is a real patient
who was admitted to St John Hospital and
Medical Center in 2005. While usually
residents can learn one or two aspects of
medicine from any single admission. This
patient taught the team about 20 lessons on
electrolytes and metabolic bone disease.

The interesting case of M.M. is a poignant
reminder of the unspoken contract be-
tween residents and patients, \u201cI\u2019ll treat you
and at the same time I will learn the craft
of medicine.\u201d Every talented physician
owes more of his knowledge to scores of
patients than to Tinsley Harrison, Burton
\u201cBud\u201d Rose or the residents of Wash U.

This chapter is dedicated to the patients and
to the debt of knowledge we owe them.
Case Report!
4
Calcium Balance!
5
Total body calcium!
5
Physiology of Calcium Regulation!
7
Hypercalcemia!
10
Primary hyperparathyroidism!
10
Hypercalcemia of malignancy!
11
Granulomatous disease!
12
Milk-alkali syndrome!
12
Symptoms of Hypercalcemia!
12
Treatment of hypercalcemia!
13
2
Hyperparathyroidism!
14
Primary vs Secondary vs. Tertiary hyperparathyroidism! 14
Renal Osteodystrophy!
16
Treating secondary hyperparathyroidism/ROD!
18
Treatment options!
19
Hypocalcemia!
20
Etiologies:!
20
Tissue deposition!
21
Increased renal loss!

21 Decreased intake and mobilization of skeletal reserves! 21 Hypocalcemia of critical illness!

22
Consequences of hypocalcemia!
23
Treatment!
24
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will u plz send me this seminar. dr avinash dravipaul@gmail.com

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