Flashcards in Hypocalcaemia Deck (19)
What is the normal range of calcium?
2.10 - 2.60
What is mild hypocalcaemia?
What is moderate hypocalcaemia?
What is severe hypocalcaemia?
Mild: 2.00 - 2.10
Moderate: 1.9 - 2.00
What is the main clinical manifestation of hypocalcaemia?
Various forms of tetany.
What is tetany?
Repetitive discharge of peripheral nerves after a single stimulus.
What symptoms are related to tetany?
Muscle stiffness, spasms, cramps
Shortness of breath (due to diaphragmatic spasms)
Other than tetany, what symptoms are associated with hypocalcaemia?
Emotional lability / psychosis
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.
What are the main categories of causes of hypocalcaemia?
Low Ca intake
Vitamin D deficiency (Vitamin D stimulates calcium resoprtion)
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
What is the most common cause of hypocalcaemia?
(Typically secondary to surgical thyroidectomy, other neck surgery, or radioactive iodine therapy)
What causes hypoparathyroidism?
- Surgical thyroidectomy
- Radioactive iodine therapy for Grave's/thyroid cancer
- Autoimmune hypoparathyroidism
What are the main causes of vitamin D deficiency?
- Poor dietary intake
- Poor UV exposure
Name some miscellaneous medical conditions that can cause hypocalcaemia:
Osteoblastic bone mets
Acute respiratory alkalosis (Ca becomes bound to albumin, dropping ionised Ca)
How do you treat hypocalcaemia?
- Vitamin D
What are the main forms of oral calcium?
Who is eligible for IV Ca replacement?
Severe symptoms (tetany/seizures)
ECG changes (prolonged QT interval)
What is the main form of IV Ca?
When is vitamin D supplementation required?
When hypocalcaemia is due to:
- vitamin D deficiency