I’m entering a few months prep for the UK and Ireland exit exam in Emergency Medicine: the FRCEM. I’ll be adding lots of little notes on pearls I’ve learned along the way. A lot of my revision is based around the Handbook of EM as a curriculum guide and review of contemporary, mainly UK guidelines. I also focus on the areas that I’m a bit sketchy on. With that in mind I hope they’re useful.
You can find more things on the FRCEM on this site here
Name some causes of hyper Ca
- of note 20% of hyperCa with malignancy has no bone mets
- even in those with bone mets the commonest mechanism of hyper Ca is known as Humoral hypercalcaemia and from the tumour producing “parathyroid hormone related peptide” (ref)
- paraneoplastic syndromes
- prolonged cuff time when measuring
What are the ECG changes?
- QT shortening (of note in hypocalcaemia the QT gets longer but that’s about the only ECG change
- J waves (osborne waves) can happen
- eventually can have ventricular arrhthmia
- widening of the QRS
- diruetics (not without its critics)