HYPOCALCEMIA

Question 1

How can the calcium level
be determined with
hypoalbuminemia?

Answer 1

(4-measured albumin level) X 0.8, then
add this value to the measured calcium
level

Question 2

What are the surgical

causes?

Answer 2

Short bowel syndrome, intestinal bypass,
vitamin D deficiency, sepsis, acute
pancreatitis, osteoblastic metastasis,
aminoglycosides, diuretics, renal failure,
hypomagnesemia, rhabdomyolysis

Question 3

What is Chvostek’s sign?

Answer 3

Facial muscle spasm with tapping of
facial nerve (Think: CHvostek = CHeek)

Question 4

What is Trousseau’s sign?

Answer 4

Carpal spasm after occluding blood flow

in forearm with blood pressure cuff

Question 5

What are the signs/

symptoms?

Answer 5

Chvostek’s and Trousseau’s signs, perioral
paraesthesia (early), increased deep tendon
reflexes (late), confusion, abdominal
cramps, laryngospasm, stridor, seizures,
tetany, psychiatric abnormalities (e.g.,
paranoia, depression, hallucinations)

Question 6

What are the ECG findings?

Answer 6

Prolonged QT and ST interval (peaked T

waves are also possible, as in hyperkalemia)

Question 7

What is the acute

treatment?

Answer 7

Calcium gluconate IV

Question 8

What is the chronic

treatment?

Answer 8

Calcium PO, vitamin D

Question 9

What is the possible complication
of infused calcium if
the IV infiltrates?

Answer 9

Tissue necrosis; never administer
peripherally unless absolutely necessary
(calcium gluconate is less toxic than
calcium chloride during an infiltration)

Question 10

What is the best way to check

the calcium level in the ICU?

Answer 10

Check ionized calcium