Acute Hypocalcaemia Flashcards
Serum Calcium result for Acute Hypocalcaemia?
<2.20
Neuro Clinical Features of Acute Hypocalcaemia (7)
Neuromuscular Irritability (Tetany) Paraesthesia Muscle Twitching Carpopedal Spasm Seizures Laryngospasm Bronchospasm
Cardiac Clinical Features of Acute Hypocalcaemia (5)
Prolonged QT Interval Hypotension Heart Failure Arrythmia Papilloedema
Clinical Features of Chronic Hypoglycaemia (7)
Ectopic Calcification (Basal Ganglia) Extrapyramidal Signs Parkinsonism Dementia Subscapular Cataracts Abnormal Dentition Dry Skin
Which signs are present in Acute Hyopocalcaemia (2)
Chovstek
Trousseu
Which nerve is involved n Acute Hypocalcaemia Chovstek Sign?
Facial Nerve
Causes of Hypocalcaemia (9)
Total Thyroidectomy Parathyroidectomy Severe Vit D Deficiency Mg2+ Deficiency Cytotoxic Drug Induced Hypocalcaemia Pancreatitis Rhabdomyolysis Large Blood Transfusions
Low PTH (Hypoparathyroidsm) Causes of Hypocalcaemia?
Total Thyroidectomy Parathyroidectomy Autoimmune Granulomatous Iron Overload Mets Radiation Post Parathyroidectomy HIV
High PTH (Secondary Hyperparathyrodism) causes of Hypocalcaemia (7)
Vit D Deficiency Pseudohypoparathyrodism Hypomagnesmia Renal Disease Tumor Lysis Acute Pancreatitis Acute Respiratory Alkalosis
Which drugs can cause Hypocalcaemia? (4)
Bisphosphonates
Calcitonin
Denosumab
Phenytoin
Investigations for Hypocalcaemia? (8)
ECG Serum Calcium Albumin Phosphate PTH U+E Vit D Magnesium
Most important investigation for Hypocalcaemia
PTH
If PTH is high when checking for Hypocalcaemia what to do next?
Check Urea and Creatinine
If Urea and Creatinine are high what does this indicate
Renal Failure
If PTH is low when checking for Hypocalcaemia what do next?
Check Magnesium
Hypoparathyrodism as part of Hypocalcaemia may result from? (6)
Agenesis eg DiGeorge Destruction eg Autoimmune Infiltration eg Wilsons or Haemochromatosis Reduced Secretion of pTH Resistance to PTH
When does Pseudohypoparathryodism present?
Childhood
Where does Pseudohypoparathryodism target
Kidney and Bone
What does Pseudophypoparathyrodism not respond to
PTH
What is Pseudohypoparathyrodism characterised by? (3)
Hypocalcaemia
Hyperphosphatemia
Elevated PTH Concentration
What can occur in Pseudohyoparathyrodism (4)
Ostoedystrophy
Obesity
Short
Shortening of Metacarpals
Treatment of Mild Hypocalcaemia (Asymptomatic, >1.9mmol)
Oral Calcium
Vit D Supplements
Treatment of Severe Hypocalcaemia
Symptomatic or <1.9mmol
Medical Emergency
IV Calcium Gluconate
ECG Monitor
5% Dextrose
What is the maintenance dose of Vit D Replacement in Hypocalcaemia
400-1000 units
If patients with severe renal impairment need fit d therapy what should be prescribed
Hydroxylated Derivvatives Alfacalcidol or Calcitriol
