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MLAB 2401: Clinical Chemistry Keri Brophy-Martinez. Diseases of Mineral and Bone. Hypercalcemia. Blood calcium levels above expected range Causes of: Malignancy Primary Hyperparathyroidism Renal Failure Multiple myeloma. Clinical Symptoms of Hypercalcemia. CNS Disorientation Lethargy
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MLAB 2401: Clinical ChemistryKeri Brophy-Martinez Diseases of Mineral and Bone
Hypercalcemia • Blood calcium levels above expected range • Causes of: • Malignancy • Primary Hyperparathyroidism • Renal Failure • Multiple myeloma
Clinical Symptoms of Hypercalcemia • CNS • Disorientation • Lethargy • Confusion • Depression • GI • Constipation • Nausea • Vomiting • Renal • Kidney stones • Skeletal • Increased risk of fractures • Cardiovascular • Hypertention
Hypocalcemia • Blood calcium levels below the expected range • Causes of: • Hypoparathyroidism • Decreased vitamin D • Inadequate diet • Malabsorption • Decreased magnesium • Decreased calcium intake
Clinical Symptoms Of Hypocalcemia • Neuromuscular irritability • Muscle cramps • Seizures • Tetany • Cardiac irregularities
Metabolic Bone Diseases • Abnormal mineralization of bone • Deficiency of vitamin D • Rickets • Disease state in growing bone (children) • Bony deformities • Osteomalacia • Adults • Loss of bone mass/ bone tissue • Osteoporosis • Affects women predominantly • Increased risk for fractures, especially hip
Hypermagnesemia • Increased magnesium • Causes of: • Acute/chronic renal failure • Decreased excretion • Endocrine disorders • Antacids • Bone cancers • Severe dehydration • Diabetic acidosis
Cardiovascular Neuromuscular • Hypotension • Bradycardia • Warm skin • Nausea • Vomiting • Lethargy • Decreased reflexes • Respiratory depression • Hypocalcemia Clinical Symptoms of Hypermagnesemia
Hypomagnesemia • Decrease in the blood level of magnesium • Causes of: • Reduced Intake • Decreased Absorption • Increased excretion- RENAL • Increased excretion-ENDOCRINE • Increased excretion-DRUG INDUCED
Cardiovascular Psychiatric • Hypertension • Arrhythmia • Weakness • Cramps • Tetany • Depression • Agitation • Psychosis Clinical Symptoms of Hypomagnesemia
Hyperphosphatemia • Elevated levels of phosphate in the blood • Caused by: • Decreased renal excretion • Acute/chronic renal failure • Increased intake • Oral, rectal, IV administration • Increased extracellular load • Acidosis, shifting of ions
Clinical Symptoms of Hyperphosphatemia • No direct symptoms
Hypophosphatemia • Decreased level of blood phosphate • Caused by: • Increased urinary excretion • Altered internal redistribution • Decreased intestinal absorption
Clinical Symptoms of Hypophosphatemia • Present once phosphorus levels decrease to one-half the lower limit of normal. • Weakness • Dizziness • Respiratory Failure • Impairment of cardiac contractility
References Bishop, M., Fody, E., & Schoeff, l. (2010). Clinical Chemistry: Techniques, principles, Correlations. Baltimore: Wolters Kluwer Lippincott Williams & Wilkins. Sunheimer, R., & Graves, L. (2010). Clinical Laboratory Chemistry. Upper Saddle River: Pearson .