Metabolic

Question 1

hypocalcaemia sx + ECG changes

Answer 1

ECG: QTc elongation, dysrhythmia

Sx: tetany- muscle twitching, cramping, spasm, perioral pareasthesia, paraesthesia

Question 2

Trousseaus sign

Answer 2

carpal spasm if brachial art occluded by inflating BP cuff _ maintaining pressure above systolic. Wrist flexion + fingers drawn together

Question 3

Chvostek’s sign

Answer 3

tapping over parotid causes facial m to twitch

Question 4

Signs of hypocalcaemia

Answer 4

Trousseau’s + Cchvostek’s sign

Question 5

mx of hypocalcaemia

Answer 5

iv calcium gluconate 10ml f 10% solution over 10min

mild 1.9-2.2 asx: po supplement
severe <1.9/ sx= ov replaceent

Question 6

hyperkalaemia ECG

Answer 6

tall tented T waves, small P waves/ loss of P waves
widened QRS -> sinusoidal patter + asystole

Question 7

Mx hyperkalaemia

Answer 7

iv ca2+ gluconate
sort term: combined insulin/dextrose infusion, nebulised salbutamol, removal: Ca2+ resonium, loop diuretics, dialysis

Question 8

hypercalcaemia

Answer 8

rehydration with normal saline
bisphosphonate: 2-3 days to work with max effect being seen ta 7d

other: calcitonin-> quicker effect than bisphosphnate, steroids in sarcoidosis