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Flashcards in Hypocalcaemia Deck (19)
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1

What is the normal range of calcium?

2.10 - 2.60

2

What is mild hypocalcaemia?
What is moderate hypocalcaemia?
What is severe hypocalcaemia?

Mild: 2.00 - 2.10
Moderate: 1.9 - 2.00
Severe: <1.9

3

What is the main clinical manifestation of hypocalcaemia?

Various forms of tetany.

4

What is tetany?

Repetitive discharge of peripheral nerves after a single stimulus.

5

What symptoms are related to tetany?

Perioral parasthesias
Muscle stiffness, spasms, cramps
Shortness of breath (due to diaphragmatic spasms)
Diaphoresis

6

Other than tetany, what symptoms are associated with hypocalcaemia?

Hypotension
Emotional lability / psychosis

7

What ECG changes are associated with hypocalcaemia?

Long QT interval (T wave happens a long time after QRS complex)

Long QT interval is more than 11 small squares from beginning of QRS to end of T.

8

What are the main categories of causes of hypocalcaemia?

Low Ca intake
Vitamin D deficiency (Vitamin D stimulates calcium resoprtion)
PTH deficiency

9

What is calcitriol?

The active form of vitamin D. It stimulates:
- Calcium absorption in the gut
- Calcium reabsorption in the renal tubules
- Bone resorption

More calcitriol ---> more calcium

10

What is the most common cause of hypocalcaemia?

Hypoparathyroidism

(Typically secondary to surgical thyroidectomy, other neck surgery, or radioactive iodine therapy)

11

What causes hypoparathyroidism?

- Surgical thyroidectomy
- Radioactive iodine therapy for Grave's/thyroid cancer
- Autoimmune hypoparathyroidism

12

What are the main causes of vitamin D deficiency?

- Poor dietary intake
- Poor UV exposure

13

Name some miscellaneous medical conditions that can cause hypocalcaemia:

Osteoblastic bone mets
Pancreatitis
Acute respiratory alkalosis (Ca becomes bound to albumin, dropping ionised Ca)
Hyperphosphataemia
Bisphosphonates

14

How do you treat hypocalcaemia?

Supplementation of:
- Calcium
- Vitamin D
- Magesium

15

What are the main forms of oral calcium?

Calcium carbonate
Calcium citrate

16

Who is eligible for IV Ca replacement?

Severe symptoms (tetany/seizures)
ECG changes (prolonged QT interval)
Abrupt decrease

17

What is the main form of IV Ca?

Calcium gluconate

18

When is vitamin D supplementation required?

When hypocalcaemia is due to:
- hypoparathyroidism
- vitamin D deficiency

19

What must you always do before you attempt to correct Ca levels?

First check and correct magnesium.