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25 Cards in this Set
- Front
- Back
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What is the normal range of ionied calcium
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1.10 to 1.32
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Which are the neurological and opthal medications of Hypocalcemia – apart from the usual
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Premature cataract
Basal ganglia calcification Pseudotumor cerebri |
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What are cardiac features of Hypocalcemia
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Depressed systolic function
QT prolongation |
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Define post surgical hypoparathyroidism
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Insufficient PTH production to maintain Normocalcemia , 6 months after surgery
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What is the risk of Hypoparathyroidism post thyroid surgery
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Risk is around 1 %
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Which other electrolyte produces Functional hypoparathyroidism
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Magnesium deficiency or excess can cause functional hypoparathyroidism
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How does Hypomagnesemia effect PTH secreation
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Magnesium is essential for release of PTH
In Hypomagnsemia PTH levels are inappropriately low despite hypocalcemia |
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How does Hypermagnsemia affect PTH release
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Parenteral Magnesium or accumulation of Magnesium in case of Renal insufficiency can cause inhibition of PTH release
Magnseium inhibits the extracellular calcium sensing receptor Pearl: Both high and low Magnesium level affects release of PTH |
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What is Autosomal dominant hypocalcemia
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It is activating mutation in Calcium sensing receptor
Also called Familial hypercalciuric hypocalcemia |
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Name some genetic causes of Hypoparathyroidism
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Di George syndrome
Kanney Caffey syndrome Barakat syndrome Familial hypoparathyroidism Keyner’s Seyere syndrome |
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Which genes are involved in Familial hypocalcemia
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GCM2
SOX3 GATA3 GCMB |
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Hypoparathyroidism is seen in which autoimmune syndrome
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Autoimmune polyglandular Endocrinopathy 1 (APS1)
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Describe the Chovstek’s sign
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the cheek is tapped
o 2 cm anterior to ear lobe o Below the zygoma Positive test is o Upward twitch of the ipsilateral upper lip |
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How long is the BP cuff tied for Trousseau’s sign
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For 3 min
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Give formula for corrected calcium
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Corrected calcium = measured calcium + 0.8 (4- Albumin)
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What is the importance of 24 hr urinary calcium in evaluation of Hypocalcemia
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24 hr urinary calcium low
o Hypoparathyroidism o Vitamin D deficiency 24 hr urinary calcium high o Familial hypercalciuric hypocalcemia |
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What is importance of 24 hr urinary magnesium
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Helps to determine the cause of hypomagnesemia
In presence of lo w serum magnesium, urinary magnesium should also be low If it is high, it suggests that Magnesium wasting in kidney is the cause of low Mg. Figure 1CAUSE OF HYPOPARATHYROIDISM Figure 2 PSEUDOHYPOPARATHYROIDISM |
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Which subtype of Bartter’s is associated with CaSR gene
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Type V Bartter’s
TREATMENT |
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When is IV and when is Oral treatment given
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IV treatment is necessary when there are acute syptoms , irrespective of the calcium levels
Oral treatment is necessary when there are no acute symptoms |
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What is the dose and method of giving calcium infusion in acute hypocalcemia patient
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1 gram of Calcium gluconate (having 93 mg of elemental calcium) is given over 10 min with ECG monitoring (RULE OF 10: 10 ml of 10% calcium gluconate over 10 min)
Followed by 10 grams in 1 litre of 5% Dextrose 60 mg/hr (5 vials in 500 ml @ 100 ml/hr) |
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Describe the calcium gluconate vial
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10 ml vial
10 % calcium gluconate Each 10 ml contains 93 mg of elemental calcium equal to 1 gram of calcuium gluconate |
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What is the dose of Calcitriol used in treatment of Hypoparathyroidism
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0.25 – 1 ug – two to three times a day
ROLSICAL – 0.25 UG TWICE DAILY |
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What is the dose of Calcium carbonate required
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500-1000 mg three times a day
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Which diet has high phosphate
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Meat
Eggs Dairy products Cola beverages Patient with Hypoparathyroidism advised low phosphate diet |
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What are targets of treatment
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Corrected calcium – low end of normal – 8 – 8.5 mg/dl
Urinary calcium <300 mg/day Calcium phosphate product <55 |
