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vitamin D
parathyroid hormone
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Total body Calcium± 1100-1200 Gm
(1.5% of body weight)

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Total body Calcium± 1100-1200 Gm


(1.5% of body weight)
1. Skeleton (99%)
a. Rapidly Exchangeable reservoir

b. Stable calcium
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a. 41% ( 1 mmol/L) -
combination with plasma
protein and is non-diffusible
through capillary
membrane
b. 9% ( 0.2 mmol/L ) -
diffusible , complex
c. 50% - diffusible and ionized
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ë Two condition :
1. Hyperparathyroidism
2. Hypoparathyroidism

 
 
 

ë 4 normal low parathyroid


hormones levels.
ë Occurs rarely and results in
decreased serum calciumÄ
calciumÄ
c  
  

Ôue to damage or removal parathyroid


gland during thyroidectomy

Hypocalcemia,,
Hypocalcemia

phosphate levels, decrease activation of


vitamin Ô

  
ë um ness
ë Tingling around mouth,
fingertips
ë Muscle spasms of hand and feet
ë Tetany
ë Laryngospasms

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ë malcium & phosphorus levels , assess


for mhvostek & Trousseau·s signs.
ë Rule out other causes of
hypocalcemia (renal
failure,a sor tion or nutritional
disorders).
 
ë Treat hypocalcemia
ë IV calcium gluconate (severe cases)
ë Long
Long-
-term therapy with
supplemental calcium
ë Ôietary teaching
ë Vitamin Ô therapy (a sor calcium)

  
 
 
ë Increase secretion of
parathyroid hormone (PTH)
affecting kidneys, ones.
ë Occurs rarely and results in
increased serum calcium.
c  
  

Tumor or hyperplasia of
parathyroid

Resulting
hypercalcemia,hypophosphatemia

  
ë 4symptomatic
ë Behaviors :
- Bone decalcification(increase
of one fractures)
- Renal calculi
- 4 dominal pain, constipation
ë 4lso have dysrhythmias,
dysrhythmias,
muscle weakness.
  

ë Blood test :
-Serum calcium
-Phosphorus
-Magnesium
-Electrolytes
m 
ë Bone x-
x-rays
ë Scans
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1. Focus on decreasing calcium levels
2. Increase fluid intake, remain
active
3. 4void calcium supplements,
thiazide diuretics
4. Severe hypercalcemia involves
hospitalization & iv saline
m 
M. Medication :-
:-
ß 4lendronate (Biophosphates
Biophosphates))
ß Pamidronate
 
 
 


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