Hypercalcemia, (High Blood Calcium) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
()
About this ebook
Hypercalcemia is too much calcium (above 10.4 mg/dL or 2.6 mmol/L) in the blood.
Normal blood Calcium varies from 8.4 to 10.4 mg/dL (2.25-2.6 mmol/L).
In hypercalcemia, just over 50% of the circulating calcium is protein bound and the level of circulating protein, mainly albumin, must also be considered in making this measurement.
The value for serum calcium is often given by laboratories as both an uncorrected value and a corrected value which has permitted for changes in albumin levels.
It is only the ionized (unbound) calcium which is important the body, taking part in cellular activities such as neuromuscular contraction, coagulation and other cellular activities.
Raised calcium concentrations are linked with significantly decreased quality of life and higher healthcare consumption.
Calcium has an important part to play in the effective working of the majority of cells in the body and it is therefore essential that the optimal level be maintained by the body.
A decrease in serum calcium can stimulate parathyroid hormone (PTH) release which may then raise bone resorption, increase renal calcium reabsorption, and activate renal conversion of 25-hydroxyvitamin D3, to the active 1,25-dihydroxyvitamin D3, which then will raise intestinal calcium absorption.
These mechanisms restore the serum calcium to normal and restrict further production of PTH and 1,25-dihydroxyvitamin D3
Parathyroid hormone (PTH) and Vitamin D help organize calcium balance in the body.
PTH is produced by the parathyroid glands.
Vitamin D is received when the skin is exposed to sunlight, and from dietary sources.
The most frequent cause of high calcium blood level is excess PTH secreted by the parathyroid glands happening due to:
1. An enlargement of one or more of the parathyroid glands.
2. A growth on one of the glands.
Most of the time, these growths are benign.
3. Calcium blood level may also be high if the body is low on fluids or water.
Other disorders can also cause hypercalcemia:
1. Certain kinds of cancers, such as lung and breast cancer, or cancer that has spread to the organs.
2. Too much vitamin D in the system.
3. Being on bed rest for a long time.
4. Being bed-bound (or not being able to move) for a long period of time.
5. Too much calcium in the diet.
The disorder is most often diagnosed at an early stage using routine blood tests.
Most people are asymptomatic.
Symptoms due to high calcium level may be varying, dependent on the cause and the duration the disorder has been present:
1. Digestive symptoms, such as nausea or vomiting, poor appetite, or constipation
2. Raised amount of thirst or more frequent urination, due to changes in the kidneys
3. Muscle weakness or twitches
4. Alterations in how the brain works, such as feeling tired or fatigued or confused
5. Bone pain and long-term spine alterations, if the bones have become thinner or weaker
An accurate diagnosis is required in hypercalcemia
Investigations
1. Serum calcium and phosphate
2. Serum PTH
3. Serum PTHrP (PTH-related protein)
4. Serum alkaline phosphatase
5. Blood albumin and proteins
6. Urine calcium and phosphate
Acute hypercalcemia is a medical emergency because of its effect on the heart rhythm.
1. Immediate treatment of intravenous isotonic saline and replacement of salt in a hospital raising the circulating volume with 0.9% saline
2. A powerful diuretic such as frusemide to reduce fluid overload
3. Phosphate intravenously or orally can also be effective to decrease the calcium from the blood
4. After rehydration, bisphosphonates, Salmon Calcitonin, steroids decrease the high blood calcium
People with primary hyperparathyroidism may need surgery.
TABLE OF CONTENT
Introduction
Chapter 1 Hypercalcemia
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Trea
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Hypercalcemia, (High Blood Calcium) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Hypercalcemia,
(High Blood Calcium)
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2017 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes Hypercalcemia, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.
(What The patient Need to Treat Hypercalcemia)
This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank the patient for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.
This autobiolographical account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Disorders
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 800 amazon kindle books and 200 into Smashwords.com eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical disorders.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
Hypercalcemia
Hypercalcemia is too much calcium (above 10.4 mg/dL or 2.6 mmol/L) in the blood.
Normal blood Calcium varies from 8.4 to 10.4 mg/dL (2.25-2.6 mmol/L).
In hypercalcemia, just over 50% of the circulating calcium is protein bound and the level of circulating protein, mainly albumin, must also be considered in making this measurement.
The value for serum calcium is often given by laboratories as both an uncorrected value and a corrected value which has permitted for changes in albumin levels.
It is only the ionized (unbound) calcium which is important the body, taking part in cellular activities such as neuromuscular contraction, coagulation and other cellular activities.
Raised calcium concentrations are