Calcium

Question 1

What is normal iCal?

Answer 1

1.2 - 1.38 mmol/L

Renal S15

Question 2

Ionized Calcium is affected by?

Answer 2

Albumin levels and pH

Renal S15

Question 3

What hormones regulate Calcium?

Answer 3

1. Parathyroid Hormone - ↑’s GI absorption, renal reabsorption and stimulate release of Calcium from bones
2. Vitamin D - augments intestinal Calcium absorption
3. Calcitonin - promotes calcium storage into the bone

Renal S15

Question 4

What causes Hypocalcemia?

Answer 4

• ↓Parathyroid hormone (PTH) secretion
• Magnesium deficiency (required for PTH production)
• Low Vit D
• Renal failure
• Massive blood transfusion (citrate preservative binds Ca++)

Renal S16

Question 5

What are the s/s of Hypocalcemia?

Answer 5

• Irritability
• Seizures
• HoTN
• Myocardial depression
• Prolonged QT interval
• Paresthesias
• Post-Parathyroidectomy-hypocalcemia-induced laryngospasm (life threatening complication)

Renal S18

Question 6

What causes Hypercalcemia?

Answer 6

Majority:
- hyperparathyroid or cancer

Less common:
- Vit D intoxication
- Milk-alkali syndrome (excessive GI Ca++ absorption)
- Granulomatous diseases (sarcoidosis)

Renal S17

Question 7

What are the s/s of Hypercalcemia?

Answer 7

• Confusion, lethargy
• Short QT interval
• Abd pain
• N/V
• Hypotonia/↓DTR

*Chronic ↑Ca++→ Hypercalciuria & nephrolithiasis

Renal S18