Hypocalcemia

Question 1

Aetiology

Answer 1

CKD (Decrease in Vit D activation)
Severe Vit D deficiency
Hypoparathyroidism
Drugs:
- Bisphosphonates
- Calcitonin
Acute Pancreatitis

Question 2

Risk Factors

Answer 2

Hypoparathyroidism
Vit D deficiency
Hyperventilation
Drugs
Malignancy
Toxic shock

Question 3

Pathophysiology

Answer 3

Ca2+ levels controlled by PTH - released from parathyroid glands when ionised Ca2+ is low
Ca2+ is absorbed at about 10% efficiency + the absorption relies upon Vit D
Any factor causing a rise in phosphate such as renal failure will cause fall in ionised Ca2+

Question 4

Symptoms

Answer 4

CATSgonumb
Convusions
Arrhythmias
Tetany
Numbness
Increase in muscle tone + contractin

Question 5

Signs

Answer 5

Chevosteks Signs - Tapping facial nerve induces spasm (C7)
Trousseaus - BP cuff causes wrist to flex and fingers to draw together

Question 6

Diagnosis

Answer 6

ECG - Long QT on ECG
PTH always high in primary Hypoparathyroidism

Question 7

Treatment

Answer 7

Treat underlying cause
- IV calcium gluconate + vit d