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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 ... DIAGNOSTIC WORKUP
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What is the calcium level? If this is increased, one should look for primary hyperparathyroidism and bone metastasis. These two findings can be further differentiated with parathyroid hormone (PTH) assay. If calcium is decreased ... DIAGNOSTIC WORKUP
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Is the patient receiving heparin therapy? As many as 27% of patients taking heparin have an elevated aspartate aminotransferase [AST, or serum glutamine-oxaloacetic transaminase (SGOT)], and 60% have an elevated alanine ... DIAGNOSTIC WORKUP
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What is the level of
creatine phosphokinase isoenzyme containing M and B subunits (MB-CPK)
? An elevated MB-CPK combined with elevated LDH is most likely due to a myocardial infarction, although myocarditis and ... 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... 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
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... When the chemistry profile shows an elevation of these enzymes, recall the tissues that produce a large amount of these enzymes: the liver, heart, and skeletal muscles. This translates into hepatitis, myocardial infarction, and dermatomyositis as the principal conditions to
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... Developing a list of diagnostic possibilities for an elevated alkaline phosphatase level involves the use of biochemistry and physiology. As with other laboratory values, we need to know where alkaline phosphatase is produced, how it is transported, and how it is degraded or excreted. Alkaline
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... Hemoconcentration (increased serum albumin)*
Hyperparathyroidism
Primary
Parathyroid adenoma
Parathyroid hyperplasia
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... Pseudoelevation
Subpulmonic effusion
Diaphragmatic neoplasm
True Elevation
Intrathoracic conditions
Lobar or segmental atelectasis
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... Calcium plays an indispensable role in cell permeability, bone and teeth formation, blood coagulation, transmission of nerve impulses, and normal muscle contraction. Nearly all (99%) of the body’s calcium is found in the bones. The remaining 1%... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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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 levels... Approach ... Pictures
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... Judith A. Fisher and M. Gina Glazier
Alkaline phosphatase (ALP) is an enzyme expressed on the plasma membrane of many cells. It has two primary sources: the liver (specifically, the biliary tree) and bones (it marks new bone formation)... Approach ... Pictures
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... Judith A. Fisher and Douglas J. Ivins
In the practice of cost-effective medicine, no value is seen to routine laboratory testing. An antinuclear antibody titer (ANA) should only be ordered in cases of a clinical suspicion of a... Approach ... Pictures
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... Calcium plays an indispensable role in cell permeability, formation of bones and teeth, blood coagulation, transmission of nerve impulses, and normal muscle contraction. Nearly all (99%) of the body’s calcium is found in the bones. The... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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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... Pictures
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...
Developing a list of diagnostic possibilities for an elevated alkaline
phosphatase level involves the use of biochemistry and physiology. As with
other laboratory values, we need to know where alkaline phosphatase is
produced, how it is transported, and how it is
... READ EXCERPTS »
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