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Is the PTH assay increased? This would point to a parathyroid tumor or hyperplasia and ectopic PTH secretion.
Is the alkaline phosphatase elevated? Hypercalcemia and an increased alkaline phosphatase without an increase in PTH assay suggests ... DIAGNOSTIC WORKUP
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Is it focal or diffuse? Focal masses in the thyroid include thyroglossal cyst, toxic adenoma, colloid cyst, Riedel's struma, nontoxic adenoma, and malignancies.
Is there movement with protrusion of the tongue? This is a typical finding in ... DIAGNOSTIC WORKUP
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Calcium is the most abundant mineral in the body, with 99% stored in bone. Calcium in the plasma is either protein-bound (mostly to albumin) or is ionized and readily available for use. Serum calcium is regulated by parathyroid hormone (PTH) and vitamin D metabolites ... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Hypercalcemia is defined as total calcium >10.5 mg/dL. Hypercalcemia occurs when the resorption rate of bone mineral or the absorption of intestinal calcium exceeds the renal excretory capacity for calcium or when there is increased renal tubular... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... Hypercalcemia, may result from disorders of calcium storage, intake, regulation, and transport.
HYPERCALCEMIA
Storage
Storage of calcium is in the bone. It follows that diseases that invade the bone
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... Chvostek's sign is an abnormal spasm of the facial muscles that's elicited by lightly tapping the patient's facial nerve near his lower jaw. (See Eliciting Chvostek's sign.) This sign usually suggests hypocalcemia, but can occur normally in about 25% of cases.... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, thyroid tumors, and drugs. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of the hormone thyroxine. If no infection... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Hemoconcentration (increased serum albumin)*
Hyperparathyroidism
Primary
Parathyroid adenoma
Parathyroid hyperplasia
Parathyroid carcinoma
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... Elevated Serum Thyroid-Stimulating Hormone
Primary hypothyroidism
Overt (low free T4)
Subclinical (normal free T4)
Assay problems
... Suppressed Serum Thyroid-Stimulating Hormone
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... Hyperparathyroidism is characterized by overactivity of one or more of the four parathyroid glands, resulting in excessive secretion of parathyroid hormone (PTH). Hypersecretion of PTH promotes bone resorption and leads to hypercalcemia and... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Chvostek’s sign is an abnormal spasm of the facial muscles that’s elicited by lightly tapping the patient’s facial nerve near his lower jaw. (See Eliciting Chvostek’s sign, page 180.) This sign usually suggests hypocalcemia but can occur... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, and thyroid tumors. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of the... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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... M. Gina Glazier and Judith A. Fisher
The normal concentration of calcium in the extracellular fluid is 8.5 to 10.5 mg/dl. Symptoms usually occur when the calcium level rises to 12.5 mg/dl or above. Serum calcium... Approach ... Pictures
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... Stephen F. Wheeler and David E. Bybee
Goiter, an enlarged thyroid gland, is the most common thyroid abnormality. Goiter is termed endemic if it occurs in more than 10% of a population. Endemic goiter most commonly results from... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Differential Overview
Neck Mass
❑ Inflammatory lymphadenopathy
❑ Parotid swelling/tumor
❑ Laryngeal cancer ... Diagnostic Approach ... Clinical Findings
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... Characterized by overactivity of one or more of the four parathyroid glands, hyperparathyroidism results from excessive secretion of parathyroid hormone (PTH). Such hypersecretion of PTH promotes bone resorption and leads to hypercalcemia and hypophosphatemia. (See Bone... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Chvostek’s sign is an abnormal spasm of the facial muscles that’s elicited by lightly tapping the patient’s facial nerve near his lower jaw. (See Eliciting Chvostek’s sign.) This sign usually suggests hypocalcemia but can... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, and thyroid tumors. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of the hormone thyroxine. If no infection is present,... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Chvostek's sign is an abnormal spasm of the facial muscles that's elicited by lightly tapping the patient's facial nerve near his lower jaw. (See Eliciting Chvostek's sign, page 138.)
This sign usually suggests hypocalcemia, but can occur normally in about 25% of cases.... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, thyroid tumors, and drugs. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of the hormone thyroxine. If no infection... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
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Hypercalcemia may result from disorders of calcium storage, intake,
regulation, and transport.
Storage.
Storage of calcium is in the bone. It follows that
diseases that invade the bone will cause excessive release of calcium. Thus,
metastatic carcinoma... Pictures
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Hyperthyroidism is a serious hormonal imbalance that can lead to weight loss, anxiety, diarrhea and other symptoms. Treatments are available, and in...
While training for the Olympic games, track star Gail Devers began to suffer from a number of mysterious symptoms: weight loss, dry skin and fatigue....
Hormone replacement therapy was once used to help women combat the side effects of menopause. But recent studies indicate it may do more harm than...
