Hypoparathyroidism - Revision history

ClaireLewis: /* Evaluation */

2019-09-28T16:21:35Z

Evaluation

← Older revision		Revision as of 16:21, 28 September 2019
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	==Evaluation==		==Evaluation==
	*~~CPM~~		*CMP
	**Low serum calcium		**Low serum calcium
	**Normal alk phos		**Normal alk phos

ClaireLewis: /* Hypocalcemia */

2019-09-28T16:21:18Z

Hypocalcemia

← Older revision		Revision as of 16:21, 28 September 2019
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	''Avoid empiric treatment in patients taking digoxin due to risk for [[Stone Heart]]''		''Avoid empiric treatment in patients taking digoxin due to risk for [[Stone Heart]]''
	*Asymptomatic		*Asymptomatic
	**Calcium gluconate 1 gm PO Q6hrs		**[[Calcium gluconate]] 1 gm PO Q6hrs
	**Vitamin D (calcitriol) 0.2 mcg BID		**Vitamin D (calcitriol) 0.2 mcg BID
	*Symptomatic		*Symptomatic
	**Calcium gluconate/chloride 10mL of 10% soln IV over 10min		**[[Calcium gluconate]]/[[calcium chloride\|chloride]] 10mL of 10% soln IV over 10min
	*Correct [[hypomag]] at same time (otherwise PTH is inhibited)		*Correct [[hypomag]] at same time (otherwise PTH is inhibited)
	*Avoid phenothiazine [[antipsychotics]] (may precipitate extrapyramidal symptoms)		*Avoid phenothiazine [[antipsychotics]] (may precipitate extrapyramidal symptoms)

Rossdonaldson1: /* Disposition */

2019-03-05T05:10:20Z

Disposition

← Older revision		Revision as of 05:10, 5 March 2019
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	==Disposition==		==Disposition==
	*Admit if symptomatic hypocalcemia		*Admit if symptomatic [[hypocalcemia]]

	==See Also==		==See Also==

Rossdonaldson1: /* Causes */

2019-03-05T05:10:05Z

Causes

← Older revision		Revision as of 05:10, 5 March 2019
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	*Hypoparathyroid thus results in [[hypocalcemia]] with [[hyperphosphatemia]]		*Hypoparathyroid thus results in [[hypocalcemia]] with [[hyperphosphatemia]]

	==Causes==		===Causes===
	*Iatrogenic:		*Iatrogenic:
	**Anterior neck surgery or radiation (e.g. resection of multiple parathyroid adenomas, thyroidectomy); may be transient		**Anterior neck surgery or radiation (e.g. resection of multiple parathyroid adenomas, thyroidectomy); may be transient

Mholtz at 09:33, 11 February 2019

2019-02-11T09:33:49Z

← Older revision		Revision as of 09:33, 11 February 2019
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	*Phosphate levels (high)		*Phosphate levels (high)

	~~==Management==~~
	==Management==		==Management==
	*Treat underlying condition		*Treat underlying condition

SLuckettG: /* Causes */

2019-02-07T18:10:49Z

Causes

← Older revision		Revision as of 18:10, 7 February 2019
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	**Anterior neck surgery or radiation (e.g. resection of multiple parathyroid adenomas, thyroidectomy); may be transient		**Anterior neck surgery or radiation (e.g. resection of multiple parathyroid adenomas, thyroidectomy); may be transient
	**steroids, diuretics, antiepilptics		**steroids, diuretics, antiepilptics
	*Congenital (e.g. [[DiGeorge syndrome]]		*Congenital (e.g. [[DiGeorge syndrome]])
	*Malignancy		*Malignancy
	*Autoimmune		*Autoimmune
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	**Anterior neck surgery or radiation (e.g. resection of multiple parathyroid adenomas, thyroidectomy); may be transient		**Anterior neck surgery or radiation (e.g. resection of multiple parathyroid adenomas, thyroidectomy); may be transient
	**steroids, diuretics, antiepilptics		**steroids, diuretics, antiepilptics
	*Congenital (e.g. [[DiGeorge syndrome]]		*Congenital (e.g. [[DiGeorge syndrome]])
	*Malignancy		*Malignancy
	*Autoimmune		*Autoimmune

ClaireLewis at 00:05, 27 January 2019

2019-01-27T00:05:18Z

← Older revision		Revision as of 00:05, 27 January 2019
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	==Background==		==Background==
			*Parathyroid hormone (PTH) increases osteolysis, renal tubular resorption of calcium, and renal synthesis of 1,25-dihydroxycholecalciferol AND inhibits renal tubular reabsorption of phosphate and bicarbonate, leading to net INCREASE in serum calcium
			*Hypoparathyroid thus results in [[hypocalcemia]] with [[hyperphosphatemia]]

			==Causes==
			*Iatrogenic:
			**Anterior neck surgery or radiation (e.g. resection of multiple parathyroid adenomas, thyroidectomy); may be transient
			**steroids, diuretics, antiepilptics
			*Congenital (e.g. [[DiGeorge syndrome]]
			*Malignancy
			*Autoimmune
			*Damage from [[Heavy metals]] (e.g. copper in [[Wilson's disease]])
			*Functional hypoPTH from [[hypomagnesemia]]

	==Clinical Features==		==Clinical Features==
	*[[Hypocalcemia]]		*See [[Hypocalcemia]], [[hyperphosphatemia]]

	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Vitamin D deficiency]]		*[[Vitamin D deficiency]]
	*Pseudohypoparathyroidism		*Pseudohypoparathyroidism (renal resistance to PTH)
	*Kidney disease		*Kidney disease
	*Malabsorption		*Malabsorption
	*Iatrogenic: steroids, diuretics, antiepilptics		*Iatrogenic:
			**Anterior neck surgery or radiation (e.g. resection of multiple parathyroid adenomas, thyroidectomy); may be transient
			**steroids, diuretics, antiepilptics
			*Congenital (e.g. [[DiGeorge syndrome]]
			*Malignancy
			*Autoimmune
			*Damage from [[Heavy metals]] (e.g. copper in [[Wilson's disease]])
			*Functional hypoPTH from [[hypomagnesemia]]

	==Evaluation==		==Evaluation==
	*CPM		*CPM
	*PTH		**Low serum calcium
			**Normal alk phos
			*PTH (low or inappropriately normal in setting of hypocalcemia)
	*EKG		*EKG
	*Magnesium levels		*Magnesium levels
	*Phosphate levels		*Phosphate levels (high)

			==Management==
	==Management==		==Management==
			*Treat underlying condition
			===Hypocalcemia===
			''Avoid empiric treatment in patients taking digoxin due to risk for [[Stone Heart]]''
			*Asymptomatic
			**Calcium gluconate 1 gm PO Q6hrs
			**Vitamin D (calcitriol) 0.2 mcg BID
			*Symptomatic
			**Calcium gluconate/chloride 10mL of 10% soln IV over 10min
			*Correct [[hypomag]] at same time (otherwise PTH is inhibited)
			*Avoid phenothiazine [[antipsychotics]] (may precipitate extrapyramidal symptoms)
			*Avoid [[furosemide]] (may worsen hypocalcemia)

	==Disposition==		==Disposition==
			*Admit if symptomatic hypocalcemia

	==See Also==		==See Also==
			*[[Hypocalcemia]], [[hyperphosphatemia]]
			*[[Electrolyte Abnormalities (Main)]]

	==External Links==		==External Links==
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	[[Category:Endocrinology]]		[[Category:Endocrinology]]
			[[Category:FEN]]

Zipdoc at 06:05, 27 March 2017

2017-03-27T06:05:41Z

← Older revision		Revision as of 06:05, 27 March 2017
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	<references/>		<references/>

	[[Category:~~Endocrine~~]]		[[Category:Endocrinology]]

Zipdoc at 06:05, 27 March 2017

2017-03-27T06:05:17Z

← Older revision		Revision as of 06:05, 27 March 2017
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	<references/>		<references/>

	[[Category:~~Endo~~]]		[[Category:Endocrine]]

Zipdoc at 06:05, 27 March 2017

2017-03-27T06:05:06Z

← Older revision		Revision as of 06:05, 27 March 2017
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	==References==		==References==
	<references/>		<references/>

			[[Category:Endo]]