1104 results
Hypercalcemia of Malignancy - Pathophysiology
PTH-mediated
 • Parathyroid cancer
 • Ectopic production: Small cell lung cancer, ovarian
intestinal calcium absorption ... and stimulates resorption ... Stimulate calcium reabsorption ... kidney, Stimulates resorption
Parathyroid Hormone (PTH) Effect in Calcium and Phosphorus
Calcium - Net Effect Hypercalcemia:
   ↑ intestinal
↑ intestinal absorption ... ↑ bone reabsorption ... ↑ tubular reabsorption ... Hypophosphatemia: ↑ bone reabsorption ... ↓↓ tubular reabsorption
Workup for Hyperphosphatemia - Differential Diagnosis Framework
Rule out spurious hyperphosphatemia: paraproteinemia, hyperlipidemia, hemolysis, hyperbilirubinemia, liposomal amphotericin
heparin Acute Phosphate ... Exogenous: Excessive phosphate ... intake, Phosphate ... Increased Renal Phosphate ... Absorption:
Hypercalcemia - Hormones and Pathophysiology  
Calcitriol:
 • Bones: Enhances mineralization
 • GI Tract: ↑ Ca2+
Kidneys: ↑ Ca2+ reabsorption ... , ↑ PO4- reabsorption ... , ↓ PO4- reabsorption ... Kidneys: ↑ Ca2+ reabsorption ... , PO4- reabsorption
Hypophosphatemia - Differential Diagnosis Algorithm
 • Decreased intake/absorption: Starvation, Alcoholism, Malabsorption, Phosphate binder use
 • Redistribution/
Decreased intake/absorption ... Malabsorption, Phosphate ... causes #nephrology #phosphate
Major Segments of the Nephron and their Functions 
 - Glomerulus - Formation of glomerular filtrate
tubule (PCT) - Reabsorption ... Isosmotic reabsorption ... Secretion and reabsorption ... loop - Passive reabsorption ... Pathophysiology #Tubules #Table
Phosphate binders - quick reference chart of maximum daily dose. Most patients with CKD will require
Phosphate binders ... CKD will require phosphate ... since they are not able ... based on serum phosphate ... aluminum-based phosphate
Hyperphosphatemia - Differential Diagnosis Algorithm
Transcellular Shift:
 • Rhabdomyolysis
 • Tumor Lysis
 • Metabolic or Respiratory Acidosis
Increased Intake / Absorption ... Hypervitaminosis D • Phosphate ... Supplementation • Phosphate
Characteristics of Commonly Used Phosphate Binders 
Aluminum 
 - Potent and effective 
 - Useful for
Commonly Used Phosphate ... - No systemic absorption ... - Significant absorption ... amzn.to/34t5DgJ #Phosphate ... #Binders #Table
Hypophosphatemia - Differential Diagnosis Algorithm
Appropriately Low Kidney Phosphate Excretion:
 • Decreased GI Absorption: Chronic Diarrhea, Antacids,
Appropriately Low Kidney Phosphate ... • Decreased GI Absorption ... Diarrhea, Antacids, Phosphate ... Inappropriately High Kidney Phosphate