Causes of Hypercalcaemia (Mnemonics)

MD PIMP ME           Malignancy   Diuretics (thiazide is main culprit)   ↑PTH      
                                    Immobilisation/Idiopathic   Megadoses of vit A, D   Paget's
                                    Milk alkali   Endocrine (Addison's, Thyrotoxicosis)

VITAMIN TRAPS    ↑VitA & D   Immobilisation   Thyrotoxicosis    Addison's dis/ Acidosis
                                    Milk-alkali   Inflammatory dis   Neoplastic   Thiazides, other drugs
                                    Rhabdomyolysis   AIDS   Paget's/ Parenteral nutrition/ Parathyroid dis
                                    Sarcoidosis    
             
GRIM FED                Granulomas (Sarcoid, TB)   Renal failure   Immobility (esp LT)   Malignancy
                                    Familial (eg familial hypocalciuric hypercalcaemia)   Endocrine
                                    Drugs (esp thiazide diuretics, lithium)

Causes of Hypercalcaemia

ENDOCRINE MALIGNANCY SARCOID DRUGS Ca INTAKE & MILK ALKALI

•1º/3º↑PTH •↑VitD •HyperT •Breast •Kidney •Thyroid •SqCC •Macrophages → 1,25VitD3 •Thiazides •Lithium

Cardiovascular Changes during Pregnancy

During pregnancy, cardiac output and blood volume increase from the second month up to the thirtieth week to 30–50% above the normal levels. The average increase in blood volume during pregnancy amounts to 1600 ml

There is also an increased metabolic workload. This produces warm extremities, a tachycardia with a large-volume pulse and a slight rise in venous pressure.


The diastolic blood pressure is lower due to vasodilatation, and this is responsible for the fading of the aortic regurgitation murmur.