Hypocalcemia

Question 1

What is the major complication of Hypocalcemia?

Answer 1

● Major problem associated with severe hypocalcemia is Tetany. When the extereacellular fluid concentration of calcium falls below normal, the nervous system becomes progressively more excitable because of increased new neuronal membrane permeability. The peripheral nerve fibers become so excitable that they begin to discharge spontaneously, initiating nerve impulses that pass to peripheral skeletal muscles, where they elicit titanic contractions. Acute hypocalcemia in the human being ordinarily causes essentially no other significant effects besides tetany, because tetany kills the patient before other effects can occur. Laryngospasm is the major threats to life.

o Low Ca causes neuron depolarization ( peripheral nerves become more permeable to Na+ and therefore are more excitable); increased release of ACh at NMJ leads to sustained muscle contraction – tetany can kill the patient (often laryngospasm)
o Treat severe hypocalcemic tetany with IV calcium gluceptate injection
o Other symptoms of hypocalcemia include paresthesias, muscle cramps, and seizures

Question 2

What are the major causes of Hypocalcemia?

Answer 2

● Hypoparathyroidism
● Vitamin D deficiency
● Renal failure

Question 3

What are the treatments for Hypocalcemia?

Answer 3

● Calcium and/or vitamin D supplementation (Vit. D is the mainstay of the therapy of
hypoparathyroidism)
● Treatment of primary disease