Hypo-calcemia Flashcards
How does the parathyroid gland react to Ca2+?
When calcium is high in the bloodstream, parathyroid stops releasing PTH.
What does PTH do at the level of the bone?
Incr osteoclast action. Clasts Clear Bone.
Serum: Increase Ca2+ and Phos.
What does PTH do at the level of the kidney?
Incr. reabsorption of Ca2+.
Incr EXCRETION of Phos.
Serum: Increase Ca2+, Decrease Phos.
How does PTH affect the gut?
Only Indirectly. Kidney converts vitamin D to the active form, which enhances the absorption of Ca2+.
In what form is most calcium in the body?
Bound to albumin. As albumin drops by 1, calcium drops by 0.8. So an albumin of 3 and a calcium of 9.2 is normal.
What is the best way to measure calcium if you suspect an abnormality?
Free ionized calcium.
What is the definition of hypocalcemia?
Serium calcium
What are the sx of hypocalcemia?
Presents with abdominal muscle cramps, dyspnea, tetany, perioral and acral paresthesias, and convulsions.
What are the PE findings of hypocalcemia?
Facial spasm elicited from tapping of the facial nerve (Chvostek’s sign) and carpal spasm after arterial occlusion by a BP cuff (Trousseau’s sign) are classic findings.
What may the EKG findings of hypocalcemia be?
Long QT interval.
What is the classic cause of hypocalcemia?
Post thyroidectomy accidental parathyroid removal, or intentional parathyroid removal.
What are other causes of hypocalcemia?
Malnutrition, hypomagnesemia, acute pancreatitis, vitamin D deficiency, and pseudohypoparathyroidism.
Treatment of hypocalcemia?
Treat the underyling disorder, replete the mag if needed, give PO or IV calcium if severe.
