hypocalcemia

related: Endocrine, Parathyroid, hypocalcemia after osteoporosis treatment, hypercalcemia
tags: #note

Causes

hyperphosphatemia: check ionized Ca.
IV bicarb can cause hypocalcemia and deposition of calcium phosphate in renal tubules
hypocalcemia is common abnormality after massive transfusion

Symptoms

mild: muscle cramps, tingling sensations
severe: seizure
long QT

Treatment

Usually do not need repletion unless ionized < 1.0. For hyperphosphatemia, repleting Ca can cause Ca-phos deposition and calciphylaxis.

Minor

oral calcium: calcium citrate or carbonate, aka tums
Calcitriol: activated vitamin D, necessary for Ca absorption

Severe

symptomatic, prolonged QTc, Ca < 7.5
IV calcium gluconate bolus followed by infusion
10 g in 1L NS over 24 hours
start PO at same time
typically ordered by endocrine consult

Backlinks

Nephrology
Nephrology
- Keywords:: Step 3, Medicine
To learns
- ANCA vasculitis
- [ ] stones: citrate and calcium physiology
MKSAP

Chapter 01Clinical Evaluation of Kidney Function Chapter 02Fluids and Electrolytes Chapter 03Acid-Base Disorders Chapter 04Hypertension Chapter 05Chronic Tubulointerstitial Nephritis Chapter 06Glomerular Diseases
- Kidney Manifestations of Deposition Diseases Chapter 08Genetic Disorders and Kidney Disease Chapter 09Acut
Parathyroid
Parathyroid
biotin supplement can cause falsely elevated or decreased PTH
Hypercalcemia
Hypercalcemia
- related: Endocrine, hypocalcemia
- tags: #note
Symptoms
- confusion
- delirium
- short QT
This patient has newly discovered hypercalcemia. Patients with mild hypercalcemia are often
Hypocalcemia After Osteoporosis Treatment
hypocalcemia after osteoporosis treatment
- related: hypocalcemia, vitamin D deficiency
The most likely diagnosis is vitamin D deficiency. Special populations will have lower levels of vitamin D owing to medical conditions or medication side effects. Obesity has been correlated with lower vitamin D levels possibly related to fat sequestration. Phenobarbital and phenytoin may increase the metabolism of vita
Rhabdomyolysis Induced AKI
rhabdomyolysis induced AKI
- related: Nephrology
- tags: #nephrology
Heme pigment released from myoglobin or hemoglobin can cause AKI through intravascular volume depletion (seen in rhabdomyolysis), renal vasoconstriction, direct proximal tubular injury, and tubular obstruction. In rhabdomyolysis, myoglobin is released in the circulation from damaged skeletal muscle. Major causes of rhabdomyolysis include ==trauma, drugs and toxins, seizures, meta
Calciphylaxis
calciphylaxis
- related: Nephrology, hypocalcemia
- tags: #nephrology
- Avoid Ca supplement in high phos When to consider
- when Ca x P > 80
Treatment
- Use sodium thiosulfate
  - SE: can cause metabolic acidosis: CO2 between 15-18
- Can also use vitamin K
Hypocalcemia Is Common Abnormality After Massive Transfusion
hypocalcemia is common abnormality after massive transfusion
- related: Hemeonc, massive transfusion protocol
- tags: #hemeonc
- blood products have citrate preservative that binds to endogenous calcium after transfusion, leading to hypocalcemia
- hypocalcemia can cause coagulopathy
- don't wait for hypocalcemia on labs. Aim for mildly elevated calcium levels in massive transfusion