Hypocalcaemia

Question 1

What is hypocalcaemia?

Answer 1

Low serum calcium

Question 2

What are the causes?

Answer 2

Low PTH

• primary or idiopathic hypoparathyroidism
• Congenital absence of parathyroid gland
• surgical removal
• radiation damage
• hypomagnesia

High PTH

• pancreatitis
• Vit D deficiency
• alkalosis

High phosphate

• renal impairment
• rhabdomyolysis
• tumour lysis

Drugs- calcitonin and bisphosphonates

Question 3

What are the symptoms?

Answer 3

Muscle cramping
Carpo-pedal flexion
-when BP taken wrist and fingers flex
Cataracts
Perioral tingling
Seizures
Depression/ Anxiety

Question 4

What investigations are needed?

Answer 4

Dependent on underlying cause

ECG- prolonged QT

Bloods

• Calcium= low
• PTH= low/raised
• phosphate= high
• magnesium= low
• U&Es= deranged

Question 5

What is the management?

Answer 5

Mild
-Adcal= Vit D and calcium

Moderate/severe

• IV calcium gluconate
• 10% of 10mls then maintenance
• start adcal

Find and treat underling cause