hypercalcemia and ulcers, pancreatitis?

[coconut lime]

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so apparently i got a kaplan question wrong because i didn't associate hypercalcemia with GI effects like constipation, ulcers, and pancreatitis. what the hell? i don't think i've EVER come across an association like this.

4 days left, i'm losing my mind!!!

 

[Idiopathic]

Can be related, or it could be Zollinger-Ellison and MEN I (parathyroid adenoma, pancreatitis, peptic ulcer disease)...the tumor in the pancreas secretes gastrin and causes excess stomach acid

 

[coconut lime]

yeah i figured MEN as well, but in this particular question, there was no mention made of it. it was simply hypercalcemia due to primary hyperPTH. F*&%'ed up!

 

[GiJoe]

Can be related, or it could be Zollinger-Ellison and MEN I (parathyroid adenoma, pancreatitis, peptic ulcer disease)...the tumor in the pancreas secretes gastrin and causes excess stomach acid

i never understood how hypercalcemia i.e. from hyper secrtion from PTH or even from long term corticosteroid use causes ulcers....

anyone know the mech?

 

[BrooklynDO]

there are a lot of associations I get wrong even though I know about them because of something in the choices, etc.... dont worry about it

 

[nuclearrabbit77]

i never understood how hypercalcemia i.e. from hyper secrtion from PTH or even from long term corticosteroid use causes ulcers....

anyone know the mech?

corticosteroid will inhibit phospholipase A2 and cox-2 with decreased prostaglandins that are necessary for gastric lumen protection. this is similar to NSAID induced gastritis mechanism.

the relationship between calcium and ulcers is definitive, but the mechanisms are not fully elucidated.

 

[nuclearrabbit77]

corticosteroid will inhibit phospholipase A2 and cox-2 with decreased prostaglandins that are necessary for gastric lumen protection. this is similar to NSAID induced gastritis mechanism.

the relationship between calcium and ulcers is definitive, but the mechanisms are not fully elucidated.

i want to clarify that i didn't mean to imply that cox-2 inhibition will cause ulcers. but inhibiting phospholipase a1, is upstream and will decrease prostaglandins regardless.

 

[nuclearrabbit77]

i want to clarify that i didn't mean to imply that cox-2 inhibition will cause ulcers. but inhibiting phospholipase a1, is upstream and will decrease prostaglandins regardless.

i meant phospholipase a2. was a typo.

 

[Idiopathic]

hypercalcemia due to primary hyperPTH. F*&%'ed up!

btw, hypercalcemia due to primary hyperPTH has to be a parathyroid adenoma, which will invariably have a MEN I relationship, in my book.

 

[nuprin]

btw, hypercalcemia due to primary hyperPTH has to be a parathyroid adenoma, which will invariably have a MEN I relationship, in my book.

not quite true. could be due to hyperplasia of the gland

 

[Idiopathic]

not quite true. could be due to hyperplasia of the gland

How could you have that...i suppose there could be idiopathic hyperplasia, but to me, that is the same as an adenoma.

 

[gisnap]

i remember reading somewhere that hypercalcemia may mediate h. pylori infection. can't recall the exact source but here's one link: http://www.ncbi.nlm.nih.gov:80/entr...ve&db=pubmed&dopt=Abstract&list_uids=12058887

 

[nuprin]

How could you have that...i suppose there could be idiopathic hyperplasia, but to me, that is the same as an adenoma.

my understanding is that it is idiopathic as you said. however, diffuse hyperplasia, (more cells throughout the gland) is different than a neoplasm (focal new growth). The major clinical difference is that an adenoma is amenable to surgical resection whereas diffuse hyperplasia is not.

 

[12R34Y]

we were told that calcium stimulates gastrin release and increases gastric acid production.

this is why you get a rebound increase in acid secretion with calcium antacids.
you should use mag or aluminum antacids instead.

later