Hypocalcemia AND hypercalcemia

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Hypocalcemia AND hypercalcemia
2011-05-07 14:33:42

For my upcoming nephrology exam
Show Answers:

  1. What is hypocalcemia?
  2. What causes hypocalcemia?
    • Chronic renal failure (via decreased production of Vit D)
    • Hypoparathyroidism
    • Vit D deficiency
    • Calcium sequestration due to: pancreatitis, massive blood transfusions (>6 units), rhabdo, tumor lysis syndrome
  3. What are sx of hypocalcemia?
    • Perioral paresthesias
    • Increased DTRs
    • +Chvostek's and Trousseau's sign
    • Irritability, psychosis, depression
  4. What does hypocalcemia show on an EKG?
    A prolonged QT interval
  5. How do you tx acute hypocalcemia?
    Calcium gluconate 1-2g IV over 20 min
  6. How do you tx chronic hypocalcemia?
    Oral CaCO2 and Vit D if indicated
  7. How do you tx hypocalcemia in a renal failure pt?
    Phosphate binders, calcitriol
  8. What is hypercalcemia?
  9. What are causes of hypercalcemia?
    • Hyperparathyroidism
    • Malignancy (SCC, breast, renal, bladder, myeloma)
    • Vit D intoxication
    • Increased bone turnover (Paget's)
  10. What are sx of hypercalcemia?
    • "bones, stones, abdominal groans, psychic moans"
    • Altered mental status, dehydration
    • Fractures, osteopenia, nephrolithiasis
    • Abd pain, anorexia, N/V, fatigue, weakness
  11. What labs do you order with hypercalcemia?
    • Calcium
    • albumin
    • Ica
    • PTH
    • PO4
  12. What do EKG changes show with hypercalcemia?
    short QT interval
  13. How do you tx acute hypercalcemia?
    Saline + loop diuretics
  14. How do you tx hypercalcemia caused by malignancies?
    Bisphosphonates, refer to onc