Case 4 - Hypocalcaemia Flashcards
1
Q
Causes of hypocalcaemia - raised phosphate
A
- CKD
- Hypoparathyroidism - inc thyroid surgery
- pseudohypoparathyroidism - insensitive to PTH
- Acute rhabdomyolysis
- Vit D deficiency
- Hypomagnesaemia
2
Q
Causes hypocalcaemia - low or normal phosphate
A
- Osteomalacia
- Acute pancreatitis
- Overhydration
- Resp alkalosis
3
Q
Immediate manegement for hypocalcaemia
A
- Mild symptoms - calcium 5mmol/6hr PO
- Severe symptoms - 10ml 10% calcium gluconate IV over 30 mins
4
Q
Potential severe complications of hypocalcaemia
A
- Arrhytmias - QT prolongation, Vtach, arrest
- Seizures
- Carpopedal spasms - Chvosteks and Trousseau sign
5
Q
What is Chvosteks sign?
A
- Tap facial nerve anterior to ear and jaw spasms
6
Q
What is Trousseau sign?
A
Inflate BP cuff and this causes carpal spasm of hand
7
Q
Long term treatment for someone with hypocalcaemia due to parathyroid removal
A
- Levothyroxine replacement
- Calcium and Vitamin D replacement
- Calcimimetics
- Bisphosphonates - prevent bone loss
- Regular TFTs and U&Es
8
Q
A
