Diferencia entre revisiones de «Hypocalcemia»
Sin resumen de edición |
Sin resumen de edición |
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| Línea 14: | Línea 14: | ||
**[[Rhabdo]] (phosphate overload) | **[[Rhabdo]] (phosphate overload) | ||
**[[Massive transfusion]] | **[[Massive transfusion]] | ||
**Systemic [[Hydrofluoric Acid]] toxicity | |||
*Decreased absorption | *Decreased absorption | ||
**Vit D deficiency | **Vit D deficiency | ||
| Línea 29: | Línea 30: | ||
==Clinical Features== | ==Clinical Features== | ||
*Paresthesias (mouth, fingertips) | *Paresthesias (mouth, fingertips) | ||
* | *↑ DTRs | ||
*Cramps | *Cramps | ||
*[[Weakness]] | *[[Weakness]] | ||
*[[Confusion]] | *[[Confusion]] | ||
*[[Seizures]] | *[[Seizures]] | ||
*Chvostek/Trousseau, Tetany | *Chvostek/Trousseau signs, Tetany | ||
*[[Hallucinations]] | *[[Hallucinations]] | ||
| Línea 65: | Línea 66: | ||
==References== | ==References== | ||
<references/> | |||
[[Category:FEN]] | [[Category:FEN]] | ||
Revisión del 08:00 3 jul 2015
Background
- Low <8.5 (<2.0 ionized)
- Low! <6.5 (<1.5 ionized)
- Correct for hypoalbumimia
- Corrected Ca = (0.8 * (Normal Alb - Pt's Alb)) + Serum Ca
Causes
- Misc
- Shock
- Sepsis
- Pancreatitis
- Hypomag
- Rhabdo (phosphate overload)
- Massive transfusion
- Systemic Hydrofluoric Acid toxicity
- Decreased absorption
- Vit D deficiency
- Increased excretion
- Endocrine
- Drugs
Clinical Features
- Paresthesias (mouth, fingertips)
- ↑ DTRs
- Cramps
- Weakness
- Confusion
- Seizures
- Chvostek/Trousseau signs, Tetany
- Hallucinations
Differential Diagnosis
Jaw Spasms
- Acute tetanus
- Akathisia
- Conversion disorder
- Drug toxicity (anticholinergic, phenytoin, valproate, carbamazepine)
- Dystonic reaction
- Electrolyte abnormality
- Hypocalcemic tetany
- Magnesium
- Mandible dislocation
- Meningitis
- Peritonsillar abscess
- Rabies
- Seizure
- Strychnine poisoning
- Stroke
- Temporomandibular disorder
- Torticollis
Diagnosis
- Trousseau's Sign (Mod to high SN and SP)
- Inflate BP cuff for 2-3 mins
- Positive = Muscle contractions of the hand and wrist
- Chvostek's Sign (Low SN and SP)
- Tapping on the face just anterior to the ear and just below the zygomatic bone
- Positive = Ipsilateral facial twitching
Treatment
Avoid empiric treatment in patients taking digoxin due to risk for Stone Heart
- Asymptomatic
- Calcium gluconate 1 gm PO Q6hrs
- Vitamin D (calcitriol) 0.2 mcg BID
- Symptomatic
- Calcium gluconate/chloride 10mL of 10% soln IV over 10min
- Correct hypomag at same time (otherwise PTH is inhibited)