Hypocalcaemia

Question 1

Hypocalcaemia causes

Answer 1

vitamin D deficiency (osteomalacia)
chronic kidney disease
hypoparathyroidism (e.g. post thyroid/parathyroid surgery)
pseudohypoparathyroidism (target cells insensitive to PTH)
rhabdomyolysis (initial stages)
magnesium deficiency (due to end organ PTH resistance)
massive blood transfusion
acute pancreatitis

Question 2

hypocalcemia features

Answer 2

muscle twitching, cramping and spasm
perioral paraesthesia
if chronic: depression, cataracts

Question 3

what is shown on ECG in hypocalcemia ?

Answer 3

prolonged QT interval

Question 4

which sign is more sensitive to hypocaclemia ?

Answer 4

Trousseau’s sign - wrist flexion and fingers are drawn together
brachial artery occluded by inflating the blood pressure cuff and maintaining pressure above systolic
seen in 95 percent

chvostek’s sign
tapping over parotid causes facial muscles to twitch
seen in around 70% of patients with hypocalcaemia and around 10% of normocalcaemic people