Electrolyte Disorders (CA) Flashcards
1
Q
When analyzing Ca levels what else should you look at
A
Albumin
2
Q
What is half of calcium bounded to
A
- Albumin
* the unbound “ionized” fraction is active
3
Q
What is the level of hypocalcemia
A
<8.2 mg/dL
4
Q
What is the etiology of hypocalcemia
A
- Hypothyroidism
- Hypoparathroidism
- Pancreatitis
- Renal insufficiency
- Crush injuries
- Necrotizing infections
5
Q
What is responsible for the immediate regulation of Ca levels
A
Parathyroid hormone
6
Q
Why are critical ill patients usually Hypocalcemic
A
- Bc of decreased albumin that often occurs
*ionized Ca may be normal
7
Q
What are the signs and symptoms of hypocalcemia
A
- Hypertension
- Peripheral and perioral paraesthesia
- Abdominal pain and cramps
- Lethargy
- Irritability in infants
8
Q
What are the common diagnostic signs of hypocalcemia
A
- Trousseau sign
*involuntary contraction of the uncles in the hand and wrist that occurs after the compression of the upper arm. With blood pressure cuff - Chvostek sign
*irritability of the facial nerve in response to tapping over the facial nerve
9
Q
What are the EKG changes for Hypocalcemia
A
- Prolonged QT interval on EKG
10
Q
What is the treatment for hypocalcemia (acute symptomatic)
A
- 100-200mg of elemental Ca IV over 10 min
*10% Ca cluconate contains 93mg of elemental Ca
*10% Ca chloride contains 272 mg of elemental Ca
11
Q
What is the treatment of Hypocalcemia (chronic)
A
- For renal insufficiency use vitamin D along with oral a supplements and phosphate-binding antacids
12
Q
What is the level for hypercalacemia
A
> 10.2mg/dl
13
Q
What are the causes of Hypercalcemia
A
- Parathyroid related
*hyperparathyroidism - Malignancy-related
*solid tumors with metastasis
*paraneopalstic syndromes - Vitamin D related
- Renal failure
14
Q
What are the signs and symptoms of Hypercalcemia
A
- Stones (renal colic)
- Bones (osteitis fibrosa)
- Moans (constipation)
- Groans (neuropsych symptoms)
15
Q
What changes will occur on the EKG (Hypercalcemia)
A
- Short QT interval
