hypocalcemia Flashcards


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1

normal ca levels

8.8-10.4 mg/dl or 2.2-2.6 mmol/l

2

results of ca & po4 concentrations

  • 55 > calcification of vascular tissue esp. in CKD
  • 60 > normal
  • 70 > capo4 crystals in soft tissues

3

RENAL Ca EXCRITION PARLLERS

Na excrition

4

hypocalcemia tests

  • low serum ca
  • low ionized ca <4.7 mg/dl
  • normal plasma proteins (albumin)
  • mg
  • PTH
  • PO4
  • alkaline phosphatase
  • vitamin D
  • x ray
  • ECG

5

causes of hypocalcemia

  1. hypoparathyroidism - pseudohypoparathyroidism
  2. renal disease
  3. vitamin d deficiency
  4. Mg depletion lead to low PTH and organ resistance
  5. acute pancreatitis lipolytic products chelate ca
  6. septic shock lead to suppress PTH release and vitamin D
  7. hyperphosphatemia
  8. anticonvulsant drugs
  9. citrate anticoagulated blood transfusion
  10. radiocontrast (ion chelate agents)
  11. medullary carcinoma of the thyroid (^calcitonin)

6

causes of hypoparathyroidism

  1. autoimmune disorders
  2. damage gland
  3. removal gland
  4. idiopathic (absent or atrophied)

7

hypo-parathyroid vs pseudohypoparathyroidism

  • hypo > PTH deficiency
  • pseduo > PTH organ resistance

8

type 1 vitamin d dependent rickets

  1. pseudo
  2. deficiency in 1a hydroxylase enzyme

9

type 2 vitamin d dependent rickets

  • organ do not respond to calciterol

10

renal tubular disease

  1. proximal renal tubular acidosis (cadmium)
  2. distal renal tubular acidosis (ca loss)

11

renal failure

  • diminished formation of calcitriol
  • renal cell damage
  • suppression of 1a hydroxylase by hyperphosphatemia

12

what is the hungry bone disease and causes?

persistent hypo ca & phosphate

  • parathyroidectomy
  • renal transpalnt
  • ESKD
  • after medical correction of hyperparathyroidism

13

what happens to ca in sever alkalosis?

  • reduction in ionized ca
  • without hypocalcemia

14

SYMPTOMYS

  • hypo PTH - short, round face, disability, calcifications.
  • muscle cramps (legs back)
  • encephalopathy
  • papilledema
  • sever - tetany, generalized seizures, hyperreflexia, laryngospasm
  • dry skin
  • brittle nails
  • coarse hair
  • candida infection
  • cataracts

15

tetany characterized by

  • paresthesia in the lops, tongue, hands, feet
  • muscle itching
  • carpopedal spasm
  • spasm in the face
  • Chvostek's sign > face
  • trousseaus sign >hands

16

trousseaus sign happens in

  • hypo
  • mg
  • k (hypo and hyper)
  • ca
  • alkalosis