Hypocalcaemia

Question 1

What level of calcium is classed as hypocalcaemia?

Answer 1

Less than 2.10 mmol/l

Question 2

What is the main causes of hypocalcaemia?

Answer 2

Renal failure

Question 3

What deficiencies can cause hypocalcaemia?

Answer 3

PTH
Magnesium
Vitamin D

Question 4

What are drug causes of hypocalcaemia?

Answer 4

Cytotoxic drugs- Bisphosphonates

Loop diuretics

Question 5

What is the pneumonic for the symptoms of hypocalcaemia?

Answer 5

SPASMODIC

Question 6

What are the symptoms of hypocalcaemia?

Answer 6

S- Spasm's (Trousseau's sign)
P- Perioral Paraesthesia 
A- Anxious/ Irritable
S- Seizures
M- Muscle tone (increased)
O- Orientation (confusion)
D- Dermatitis 
I- Impetigo herpetiformis 
C- Chovstek's sign

Question 7

What are the 2 important signs of hypocalcaemia?

Answer 7

Trousseau’s sign

Chovstek’s sign

Question 8

How is hypocalcaemia diagnosed?

Answer 8

PTH- main diagnostic test
Serum calcium
ECG
Trousseau’s sign
Chovstek’s sign

Question 9

What would you see on an ECG with hypocalcaemia?

Answer 9

Prolonged QT interval

Question 10

What is Chovstek’s sign?

Answer 10

Neuromuscular excitability by tapping over facial nerve (muscle twitching)

tapping over parotid causes facial muscles to twitch

Question 11

What is Trousseau’s sign?

Answer 11

Carpopedal spasm caused by inflating the blood pressure cuff above the systolic pressure

Question 12

What is the management of hypocalcaemia?

Answer 12

IV 10 ml 10% calcium gluconate over 10 minutes

Question 13

How is hypocalcaemia usually diagnosed?

Answer 13

PTH and symptoms

Question 14

What are the main causes of hypocalcaemia?

Answer 14

vitamin D deficiency (osteomalacia)
chronic kidney disease
hypoparathyroidism (e.g. post thyroid/parathyroid surgery)