Lecture 18 - Clinical Aspects of Hypocalcemia

Question 1

_______ syndrome arises from a 22q11.2 deletion. It results in absence of the _____ glands and dysplasia of the _____.

Answer 1

DiGeorge’s syndrome

Parathyroid glands

Thymus

Question 2

Autoimmune polyglandular syndrome type 1 includes hypoparathyroidism, Addison’s disease, and mucocutaneous candidiasis. Look for young patients with low _____, low Ca++, and oral ______.

Answer 2

BP

Candidiasis

Question 3

VitD deficiency can cause hypocalcemia. Specifically, VitD-dependent rickets type 1 arises from a deficiency in the _________ enzyme, whereas type two results from _________ receptor mutation.

Answer 3

1alpha-hydroxylase

1,25-vitD3 receptor

Question 4

__________ is a class of medications associated with hypocalcemia.

Answer 4

Anticonvulsants (also Isoniazid!)

Question 5

How do changes in QT interval compare with EKG of HYPER- vs HYPOcalcemic patient?

Answer 5

HYPER –> Shortened QT interval

HYPO –> prolonged QT

Question 6

________ cataracts are one of the characteristic ocular symptoms of hypocalcemia.

Answer 6

Subcapsular

Question 7

If given PTH, how will patients with Pseudohypocalcemia respond?

How should you treat them?

Answer 7

They won’t! They have PTH resistance.

Oral Ca++ supplementation with 1-2g elemental Ca++.

Question 8

Remember that patients with chronic hypoparathyroidism should be supplemented with active _______.

Answer 8

VitD3

Question 9

______ is a recombinant PTH drug injected subQ that has shown favorable outcomes in treatment of hypoparathyroidism.

______ diuretics can also be given to increase renal absorption of Ca++.

Answer 9

Natpara

Thiazide