Hypocalcaemia Flashcards
presentation
parathesia in fingers, toes and perioral muscle cramps, excitability, tetany bronchospasm, laryngospasm and fits asphyxiation due to constant contraction of respiratory muscles fatigue
diagnosis
chvostek sign
Trousseau sign
QT prolongation on ECG
management
IV 10ml of 10% calcium gluconate in 50% dextrose or saline
then infusions
what is calcium release from cells dependent on?
magnesium
what happens to calcium and PTH in magnesium deficiency?
calcium is high and PTH release is inhibited
skeletal and muscle receptors are less sensitive to PTH
causes of hypomagnesemia
alcohol drugs (thiazides- waste in urine and PPIs) GI illness pancreatitis malabsorption (Coeliac's, Whipple's)
management of hypomagnesaemia
calcium and magnesium replacement
define Rickets/osteomalacia
vitamin D deficiency
causes of rickets/osteomalacia
diet malabsorption renal failure lack of sunlight drugs e.g. anticonvulsants
presentation of rickets/osteomalacia
muscle wasting-proximal myopathy
dental defects (caries, enamel)
bone tenderness, rib and limb deformities
losser’s zones (fractures at edges of joints)
waddling gait
craniotabes-neonates
diagnosis of rickets/osteomalacia
calcium is low
define vitamin D resistant rickets
this is X-linked hypophosphatemia (disease of variable penetrance)
genetics of vitamin D resistant rickets
PHEX or FGF23 gene mutation
what does the FGF23 gene do?
regulates phosphate levels in plasma and is secreted by osteocytes in response to decreased calcitriol
diagnosis of vitamin D resistant rickets
low phosphate and high vitamin D
