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Hypocalcemia - Workup Algorithm

Dr Nikhil Lohiya - NEPHKIDS 2020 @NEPHKIDS1

#Hypocalcemia #Workup #Algorithm #differential #diagnosis #endocrinology #causes
Hypocalcemia - Workup ... @NEPHKIDS1 #Hypocalcemia ... #differential #diagnosis ... #endocrinology ... #causes #calcium
Causes of Hypercalcemia
Hypercalcemia due to increased bone Ca2+ resorption:
 • Primary hyperparathyroidism, Malignancy, Pseudohyperparathyroidism, Renal failure,
Causes of Hypercalcemia ... )-alkali syndrome ... #Causes #differential ... #diagnosis #calcium ... #high #endocrinology
Hypercalcemia Workup and Differential Diagnosis Framework
1) Determine whether PTH-dependent
2) Assess for other hormonal causes
3) Assess for
Hypercalcemia Workup ... and Differential Diagnosis ... other hormonal causes ... #algorithm #endocrinology ... #calcium
Hypercalcemia - Differential Diagnosis Algorithm
Elevated PTH (High or normal):
 • Primary Hyperparathyroidism
 • Familial Hypocalciuric Hypercalcemia
Low
Differential Diagnosis ... Bony Mets - Calcium ... #Differential #Diagnosis ... #Algorithm #causes ... #endocrinology
Hypocalcemia - Diagnosis and Management
PTH Independent (↑ PTH)
 • LOW VIT D
    -
Hypocalcemia - Diagnosis ... - Calcium Sequestration ... - DiGeorge Syndrome ... #Diagnosis #Management ... #endocrinology
Hyperparathyroidism - Primary vs Secondary vs Tertiary 
Lab Comparison:
 • Primary Hyperparathyroidism: ↑→PTH, ↑Calcium, ↑Vitamin D,
Phosphate Physical Symptoms ... pain Psychiatric Symptoms ... Hyperparathyroidism #diagnosis ... #endocrinology ... Secondary #Tertiary #pathophysiology
Causes of Hypercalcemia
Parathyroid gland structure-related
 • Primary hyperparathyroidism
 • Parathyroid adenoma
 • Parathyroid hyperplasia
 • Parathyroid
Causes of Hypercalcemia ... Lithium use • Calcium-sensing ... • Milk-alkali syndrome ... #Causes #endocrinology ... #diagnosis #differential
Diabetes Insipidus vs Syndrome of Inappropriate ADH (SIADH) - Comparison Table

Diabetes Insipidus - Inadequate ADH
SIADH -
Diabetes Insipidus vs Syndrome ... Comparison #Table #Pathophysiology ... #Signs #Symptoms ... #Diagnosis #Endocrinology
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 ... hypocalciuric hypercalcemia ... Other humoral syndromes ... #Causes #Differential ... #Diagnosis #Endocrinology
Causes of Hypokalemia - Differential Diagnosis Algorithm
Increased Loss 
 - Increased GI Loss
 - Increased Urinary
Causes of Hypokalemia ... - Differential Diagnosis ... - Refeeding Syndrome ... #Hypokalemia ... potassium #low #pathophysiology