Calcium, magnesium, and phosphorus abnormalities

Question 1

Should you replace calcium in patients without symptoms or rapidly changing levels

Answer 1

No

Question 2

4 common causes of hypocalcemia in the ICU

Answer 2

Hypoparathyroidism

Secondary hypoparathyroidism

Drugs

Hypomagnesemia

Question 3

5 common drugs for causing hypocalcemia

Answer 3

Bisphosphonates

Calcitonin

Citrate

Phenytoin

Foscarnet

Question 4

4 common symptoms of hypocalcemia

Answer 4

Tetany (including refractory bronchospasm)

Seizures

Hypotension w/ prolonged QT

Anxiety and psychosis

Question 5

Formula for correction of calcium for albumin in non-ionized calcium level

Answer 5

Decrease calcium 0.8 for every 1 g drop in albumin

Question 6

Dose for treatment of symptomatic hypocalcemia

Answer 6

1-2 grams over 20 minutes then infusion of calcium gluconate

Question 7

Normal ionized calcium range

Answer 7

1.1 - 1.3 mmol/L

Question 8

Calcium level above which symptoms usually present

Answer 8

> 14

Question 9

Treatment of hypercalcemia

Answer 9

Saline to maintain UOP of 100-150 mL/hr

Calcitonin

Block resorption in the bone (zolendronic acid or pamidronate)

Question 10

Treatment dose for correction of hypomagnesemia

Answer 10

1-2 g IV mag sulfate

Question 11

Amount of total body magnesium found in serum

Answer 11

0.3% (only 1% in all body fluids)

Question 12

Most common cause of hypophosphatemia

Answer 12

Refeeding syndrome

Question 13

5 symptoms of acute hypophosphatemia

Answer 13

Decreased cardiac contractility

Dysphagia

Encephalopathy

Ileus

Respiratory muscle weakness