Calcium, phosphate and bone metabolism cases 1.

A 57 year old male was found to have plasma calcium levels of 2.90 mmol/L. Normal calcium values range between 2.2-2.6 mmol/L So the above figure suggests a possible hypercalciemia b. What are the possible causes of the above findings Primary hyperthyroidism Malignancy Vitamin D metabolic disorders Disorders of high bone turnover (multiple myeloma, thiazide use, pagets disease of the bone) Renal failure ( milk alkali syndrome, aluminium intoxication ) c. What are the common signs and symptoms of a patient with calcium levels? "Stones, Bones, Groans, Thrones and Psychiatric Overtones" -Stones (renal or biliary) -Bones (bone pain) -Groans (abdominal pain, nausea and vomiting) -Thrones (sit on throne - polyuria) -Psychiatric overtones (Depression 30-40%, anxiety, cognitive dysfunction, insomnia, coma) 2. Define a. Primary hyperthyroidism b. Secondary hyperthyroidism c. Tertiary hyperthyroidism 3. Discuss hormonal regulation of calcium in the body 4. What a. Are the causes of hypocalcaemia b. List the signs and symptoms of hypocalcaemia 5. What are the causes of hyperurecemia 6. Describe renal osteodystrophy 7. Describe the biochemical findings associated with a. Rickets b. Osteoporosis Fluid and electrolyte cases 1. A patient was found to have a plasma sodium of 155mmol/L. discuss the possible causes and clinical features associated with the findings 2. Discuss hyponatrimea under the following a. Causes b. Clinical findings 3. Discuss potassium under the following:-

a. Factors affecting potassium movement into and out of the cells. b. Causes and clinical features of hyperkalemia c. Management of hyperkalemia d. Causes and clinical featuers of hypokalemia 4. Describe the causes and biochemical findings of a. Diabetes insipidus b. SIABH 5. Discuss magnesium under the following:a. Physiological functions b. Causes and clinical features of hypomagnesaemia c. Causes and clinical features of hypermagnesaemia