Hypocalcemia Flashcards
what are two PE signs of hypocalcemia?
chovstek and trosseau signs
what is the Trousseau sign?
blood pressure cuff leads to flexion of hand/fingers
what is mental sign of hypocalcemia?
agitation
what is MSK sign of hypocalcemia?
hyperreflexia
what are the two most severe issues in hypocalcemia?
seizures and long QT
muscles have tendency to be excited or relaxed in hypocalcemia?
excited
if PTH is low, what are three potential causes for hypocalcemia?
post surgical hypoparathyroid
autoimmune hypopara
genetic hypopara
what is most common low PTH low calcium cause?
post surgical
if PTH is high and you have hypocalcemia, what should come to mind?
secondary hyperparathyroid
what are tow possible causes of secondary hyperparathyroid?
vitamin D deficiency
Renal disease
explain how renal failure leads to high PTH but low calcium
kidneys are failing so they cannot reabsorb the calcium…low calcium then stimulates PTH to ramp up
what other electrolyte can lead to hypocalcemia?
extremely low magnesium
why does low magnesium lead to hypocalcemia?
has a paradoxical blocking function on the release of PTH
how do you treat hypomagnesia induced hypocalceia?
give magnesium
post surgical hypoparathyroid, how do you treat?
calcium and 1,25-D
what are labs of Ca, PTh and phosphorus in hypoparathyroid from surgery?
low calcium, low PTH and high phosphorus
what is an immune disease that can lead to hypoparathyroid and hypocalcemia?
digeorges
what is the autoimmune hypoparathyroid disease to know?
autoimmune polyglandular syndrome 1
what happens in autoimmune polyglandular syndrome 1?
have an activating antibody to the CaSR so that inhibits PTH release
what are other issues in autoimmune polyglandular syndrome 1?
candidiasis and adrenal insufficiency
how do you treat autoimmune polyglandular syndrome 1?
calcium and 1,25-D
what are values of Ca, PTh and Phosphorus seen in secondary hyperparathyroid?
low calcium
high phosphorus
increased PTH
what is treatment for secondary hyperparathyroid?
phos binders, vit D analogues, Ca
what is another name for pseudohypoparathyroid?
Albrights hereditary osteodystrophy
