Hypocalcaemia

Question 1

When is hypocalcaemia defined?

Answer 1

When calcium levels are <8.5mg/dL.

Question 2

What does parathyroid hormone do?

Answer 2

Causes the bones to release calcium and the kidneys to absorb calcium.

Question 3

What does calcitriol do?

Answer 3

Causes increased GI absorption of calcium.

Question 4

What is the most common cause of hypocalcaemia?

Answer 4

Hypoparathyroidism:
Surgical removal
autoimmune destruction
DiGeorge syndrome
Magnesium deficiency

Question 5

What are other causes of hypocalcaemia?

Answer 5

Hypoparathyroidism
Vitamin D deficiency
Hypophosphataemia 
Acute pancreatitis
Hypomagnesia
Acute alkalosis
Chronic renal failure 
Tissue burns 
Inflammation (Acute pancreatitis)
Blood transfusions

Question 6

What are the main signs of hypocalcaemia?

Answer 6

SPASMODIC:
Spasms (trousseaus sign)
Perioral parasthesia 
Anxiety
Seizures
Muscle tone increased
Orientation impaired 
Dermatitis
Impetigo herpetiformis
Chvosteks sign.

Question 7

What is chvosteks sign?

Answer 7

When there is spasming of the facial muscles after lightly tapping on the facial nerve.

Question 8

What is trousseaus sign?

Answer 8

When the BP cuff causes wrist and metacarpal flexion.

Question 9

What ECG changes can be seen?

Answer 9

Prolonged QT
Atrial fibrillation
Prolonged ST
Torsades de pointes

Question 10

What is the treatment for hypocalcaemia?

Answer 10

Calcium gluconate.
Vitamin D supplementation.

Severe - IV calcium gluconate.