Parathyroid Disorders
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First Things First (assess & treat for the following)
Hyperparathyroidism
- Does pt have severe hypercalcemia requiring immediate attention?
- Corrected serum calcium >3.5 above upper limit of normal or ionized calcium level >20% above normal value and
- Evidence of shock due to volume depletion
- Mental status changes (psychosis, lethargy, stupor, coma)
- EKG changes (short QT, arrhythmias)
- Nausea, vomiting, and abdominal pain
- Renal failure
- Corrected serum calcium >3.5 above upper limit of normal or ionized calcium level >20% above normal value and
Hypoparathyroidism
- Does pt have severe hypocalcemia requiring immediate attention?
- Corrected serum calcium < 7.5 mg/dL or ionized calcium level < 80% of normal values and
- Frank tetany, laryngospasm, perioral numbness and carpopedal spasms
- Chvostek’s sign and Trousseau’s sign (which is more specific for hypocalcemia)
- Arrhythmias: long QT, bradycardia, heart block, cardiac arrest
- Hypotension, heart failure
- Frank tetany, laryngospasm, perioral numbness and carpopedal spasms
- Corrected serum calcium < 7.5 mg/dL or ionized calcium level < 80% of normal values and
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First Things First (assess & treat for the following)
Hyperparathyroidism
- Does pt have severe hypercalcemia requiring immediate attention?
- Corrected serum calcium >3.5 above upper limit of normal or ionized calcium level >20% above normal value and
- Evidence of shock due to volume depletion
- Mental status changes (psychosis, lethargy, stupor, coma)
- EKG changes (short QT, arrhythmias)
- Nausea, vomiting, and abdominal pain
- Renal failure
- Corrected serum calcium >3.5 above upper limit of normal or ionized calcium level >20% above normal value and
Hypoparathyroidism
- Does pt have severe hypocalcemia requiring immediate attention?
- Corrected serum calcium < 7.5 mg/dL or ionized calcium level < 80% of normal values and
- Frank tetany, laryngospasm, perioral numbness and carpopedal spasms
- Chvostek’s sign and Trousseau’s sign (which is more specific for hypocalcemia)
- Arrhythmias: long QT, bradycardia, heart block, cardiac arrest
- Hypotension, heart failure
- Frank tetany, laryngospasm, perioral numbness and carpopedal spasms
- Corrected serum calcium < 7.5 mg/dL or ionized calcium level < 80% of normal values and
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