Hypocalcaemia

Question 1

Investigations

Answer 1

FBC, UE, LFT (ALP)
calcium and phosphate
PTH and magnesium
vitamin D
consider XR metacarpals, antibodies

Question 2

Acute Treatment

Answer 2

calcium gluconate IV (20ml 10% = 4.5mmol)
supplements: vit D, calcium, magnesium
find and treat cause

Question 3

presentation - SPASMODIC

Answer 3

spasm (Trousseou’s), paraesthesia, anxious, seizure, muscle hypertonia, confusion, dermatitis, impetigo, Chovosteks (facial nerve)

Question 4

hypoPTH

Answer 4

iatrogenic, idiopathic, hypoMg, bony mets

low Ca
high PO (no PTH action on kidneys)
low PTH

Question 5

CKD

Answer 5

low Ca
high PO (kidneys not working)
high PTH
high ALP (renal bone disease)

Question 6

vit D deficiency

Answer 6

low Ca
low PO (PTH + kidneys working)
high PTH
high ALP (PTH action; bone resorb)

Question 7

pseudo hypoPTH

Answer 7

PTH receptor defect

low calcium
high PO
high PTH
short neck, short metacarpals, short height, low IQ