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differential management algorithm hypercalcemia potassium adrenal nephrology workup anesthesia anesthesiology hematology intraoperative signs symptoms acth blood bradycardia bulimianervosa cardiac cardiology
Causes of Hypercalcemia Hypercalcemia due to increased bone Ca2+ resorption: • Primary hyperparathyroidism, Malignancy, Pseudohyperparathyroidism, Renal failure,
Causes of Hypercalcemia ... histoplasmosis) • Milk (calcium ... #Causes #differential ... #diagnosis #calcium ... #high #endocrinology
Hypercalcemia - Differential Diagnosis Algorithm Primary Hyperparathyroidism • Adenoma • Hyperplasia • MEN 1 and 2A Tertiary Hyperparathyroidism
Differential Diagnosis ... Autosomal Dominant Calcium ... Other • Excess Calcium ... Immobilization • Adrenal Insufficiency ... #Algorithm #Endocrinology
Adrenal Insufficiency Differential Diagnosis Algorithm Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis ... Weakness, fatigue, nausea ... hyponatremia, hyperkalemia ... likely: • High ... #Algorithm #endocrinology
Hypercalcemia - Differential Diagnosis Algorithm Elevated PTH (High or normal): • Primary Hyperparathyroidism • Familial Hypocalciuric Hypercalcemia Low
Differential Diagnosis ... Elevated PTH (High ... Bony Mets - Calcium ... #Algorithm #causes ... #endocrinology
Hyperkalemia - Management Algorithm • IV calcium • IV insulin and glucose and/or salbutamolt • Consider
Algorithm • IV calcium ... potassium and ECG ... blocks, QRS axis shift ... #potassium #high ... #diagnosis #management
Causes of Hypercalcemia Parathyroid hormone–dependent Primary hyperparathyroidism Familial hypocalciuric hypercalcemia Lithium-associated Tertiary hyperparathyroidism Genetic disorders (e.g., multiple endocrine neoplasia type 1 or
Causes of Hypercalcemia ... Genetic disorders (e.g ... thyrotoxicosis, adrenal insufficiency ... #Causes #Differential ... #Diagnosis #Endocrinology
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 Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
Diagnosis Framework ... phlebotomy High ... Intracellular Shift ... deficiency • Renal insufficiency ... #causes #potassium
Hypercalcemia Evaluation 1) Clinical clues - Is the patient symptomatic? - Family history? - Have you done
1) Clinical clues ... PTH - Frankly high ... #differential #diagnosis ... #endocrinology ... #calcium #elevated
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
Diagnosis Framework ... phlebotomy High ... Intracellular Shift ... deficiency • Renal insufficiency ... #causes #potassium
Adrenal Insufficiency - Diagnosis and Management Summary Primary Adrenal Insufficiency: Most Common Cause in the US: Autoimmune Adrenalitis Other
: Most Common Cause ... Adrenalitis Other causes ... Hyperkalemia is ... Give 250 mcg of ... #Management #Endocrinology
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