Acute Hypocalcaemia

Question 1

Serum Calcium result for Acute Hypocalcaemia?

Answer 1

<2.20

Question 2

Neuro Clinical Features of Acute Hypocalcaemia (7)

Answer 2

Neuromuscular Irritability (Tetany)
Paraesthesia
Muscle Twitching
Carpopedal Spasm
Seizures
Laryngospasm
Bronchospasm

Question 3

Cardiac Clinical Features of Acute Hypocalcaemia (5)

Answer 3

Prolonged QT Interval
Hypotension
Heart Failure
Arrythmia
Papilloedema

Question 4

Clinical Features of Chronic Hypoglycaemia (7)

Answer 4

Ectopic Calcification (Basal Ganglia)
Extrapyramidal Signs
Parkinsonism
Dementia
Subscapular Cataracts
Abnormal Dentition
Dry Skin

Question 5

Which signs are present in Acute Hyopocalcaemia (2)

Answer 5

Chovstek

Trousseu

Question 6

Which nerve is involved n Acute Hypocalcaemia Chovstek Sign?

Answer 6

Facial Nerve

Question 7

Causes of Hypocalcaemia (9)

Answer 7

Total Thyroidectomy
Parathyroidectomy
Severe Vit D Deficiency
Mg2+ Deficiency
Cytotoxic Drug Induced Hypocalcaemia
Pancreatitis
Rhabdomyolysis
Large Blood Transfusions

Question 8

Low PTH (Hypoparathyroidsm) Causes of Hypocalcaemia?

Answer 8

Total Thyroidectomy
Parathyroidectomy
Autoimmune
Granulomatous
Iron Overload
Mets
Radiation
Post Parathyroidectomy
HIV

Question 9

High PTH (Secondary Hyperparathyrodism) causes of Hypocalcaemia (7)

Answer 9

Vit D Deficiency
Pseudohypoparathyrodism
Hypomagnesmia
Renal Disease
Tumor Lysis
Acute Pancreatitis
Acute Respiratory Alkalosis

Question 10

Which drugs can cause Hypocalcaemia? (4)

Answer 10

Bisphosphonates
Calcitonin
Denosumab
Phenytoin

Question 11

Investigations for Hypocalcaemia? (8)

Answer 11

ECG
Serum Calcium
Albumin
Phosphate
PTH
U+E
Vit D
Magnesium

Question 12

Most important investigation for Hypocalcaemia

Answer 12

PTH

Question 13

If PTH is high when checking for Hypocalcaemia what to do next?

Answer 13

Check Urea and Creatinine

Question 14

If Urea and Creatinine are high what does this indicate

Answer 14

Renal Failure

Question 15

If PTH is low when checking for Hypocalcaemia what do next?

Answer 15

Check Magnesium

Question 16

Hypoparathyrodism as part of Hypocalcaemia may result from? (6)

Answer 16

Agenesis eg DiGeorge
Destruction eg Autoimmune
Infiltration eg Wilsons or Haemochromatosis
Reduced Secretion of pTH
Resistance to PTH

Question 17

When does Pseudohypoparathryodism present?

Answer 17

Childhood

Question 18

Where does Pseudohypoparathryodism target

Answer 18

Kidney and Bone

Question 19

What does Pseudophypoparathyrodism not respond to

Answer 19

PTH

Question 20

What is Pseudohypoparathyrodism characterised by? (3)

Answer 20

Hypocalcaemia
Hyperphosphatemia
Elevated PTH Concentration

Question 21

What can occur in Pseudohyoparathyrodism (4)

Answer 21

Ostoedystrophy
Obesity
Short
Shortening of Metacarpals

Question 22

Treatment of Mild Hypocalcaemia (Asymptomatic, >1.9mmol)

Answer 22

Oral Calcium

Vit D Supplements

Question 23

Treatment of Severe Hypocalcaemia

Symptomatic or <1.9mmol

Answer 23

Medical Emergency
IV Calcium Gluconate
ECG Monitor
5% Dextrose

Question 24

What is the maintenance dose of Vit D Replacement in Hypocalcaemia

Answer 24

400-1000 units

Question 25

If patients with severe renal impairment need fit d therapy what should be prescribed

Answer 25

Hydroxylated Derivvatives Alfacalcidol or Calcitriol