Hypocalcaemia Flashcards

1
Q

What are the symptoms of Hypocalcaemia?

A
Peripheral irritability (tetany, cramps, carpo-pedal spasm)
Central irritability (seizures)
Depression/anxiety
Perioral paraesthesia
Cataracts
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2
Q

What is a carpo-pedal spasm?

A

Wrist flexion/fingers drawn together

- If happens after brachial occlusion = Trosseau's sign
- If twitches when tapping facial nn = Chvostek's sign
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3
Q

How can the causes of Hypocalcaemia be separated?

A

With low PTH

With high PTH

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4
Q

What are the causes of Hypocalcaemia with low PTH?

A
Idiopathic/1o hyperparathyroidism
Post-thyroid/parathyroid surgery
Post neck irradiation
Infiltration (sarcoid, malignancy)
Congenital absence of gland (Di George)
Severe hypomagnesia
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5
Q

What are the causes of Hypocalcaemia with high PTH?

A
Vit D deficiency
Acute pancreatitis
Alkalosis
Acute hyperphosphataemia (renal failure, rhabdo, tumour lysis)
Drugs (bisphosphonates, calcitonin)
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6
Q

What investigations are appropriate in suspected hypocalcaemia?

A
Serum Ca (low)
Serum PTH (high/low) --> If low check antibodies
Serum Vit D
ECG (prolonged QT)
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7
Q

What is the management of hypocalcaemia?

A

Mild/mod sx –> AdCal
Sev sx –> Calcium gluconate IV, 10mls of 10% bolus then maintenace AND AdCal
Find/treat cause

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