{"id":5153,"date":"2011-07-14T20:23:58","date_gmt":"2011-07-14T20:23:58","guid":{"rendered":"http:\/\/crashtext.org\/misc\/electrolyte-disorders.htm\/"},"modified":"2013-03-21T17:08:52","modified_gmt":"2013-03-21T21:08:52","slug":"calcium-disorders","status":"publish","type":"post","link":"https:\/\/crashingpatient.com\/medical-surgical\/electrolyte-disorders\/calcium-disorders.htm\/","title":{"rendered":"Calcium Disorders"},"content":{"rendered":"<p>60% of body weight is water.\u00a0 2\/3 intracellular, 1\/3 extracellular.\u00a0 3\/4 is interstitial, 1\/4 plasma.<\/p>\n<p>Ca=Ca + .8(4-ALB)<\/p>\n<p>Albumin-adjusted calcium not suitable for diagnosis of calcium abnormalities, get an ionized calcium (Crit Care Med 31(5):1389, May 2003)<\/p>\n<p>&nbsp;<\/p>\n<p>Ccalc = Cobs\/(0.25ALB + 0.1)<\/p>\n<p>Ical to SI = mg\/dl x 0.5872= mmol\/L<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Hypocalcemia\"><\/span>Hypocalcemia<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>hypo-pth, Vit D deficiency, PTH resistance, Calcium chelation<\/p>\n<p>May see after large transfusion or contrast media<\/p>\n<p><strong>Chvostek<\/strong>-tapping facial nerve causes twitching (Insensitive and non-specific Neurology March 12, 2013 vol. 80 no. 11 1067)<\/p>\n<p><strong>Trousseau\u0092s<\/strong>-carpal spasm after 3 min of BP Cuff at 20 over systolic<\/p>\n<p>QT prolongation<\/p>\n<p>May see stridor<\/p>\n<p>1st step should be to get ionized Ca<\/p>\n<p>1 amp of CaCl=270 mg Ca, CaGluc=93 mg of Ca<\/p>\n<p>&nbsp;<\/p>\n<p>Rx for Severe<\/p>\n<p>0.5 mcg of ?<\/p>\n<p>Calc Gluconate<\/p>\n<p>Cal Carbonate ?500<\/p>\n<p>Ical &gt; 4<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Hypercalcemia\"><\/span>Hypercalcemia<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>HyperPTH, Malignancy Sarcoid, Vit D, or Thiazides<\/p>\n<p>Parathyroid<\/p>\n<p>Addison&#8217;s<\/p>\n<p>Multiple Myeloma<\/p>\n<p>Paget&#8217;s<\/p>\n<p>Sarcoid<\/p>\n<p>Cancer (Usually Squamous Lung CA)<\/p>\n<p>Hyperthryoid<\/p>\n<p>Milk Alkali Syndrome<\/p>\n<p>Immobilization<\/p>\n<p>D-Vitamin D<\/p>\n<p>Thiazide Diuretics<\/p>\n<p>Fluids, Furosemide, Mithramycin (lowers Ca by decreasing bone turnover, 25 mcg\/kg infused in D5W over 4-8 hours) Calcitonin, Biphosponates, Dialysis, Steroids<\/p>\n<p><cite><abbr class=\"slug-jnl-abbrev\" title=\"Neurology\">Neurology<\/abbr><span class=\"slug-pub-date\" itemprop=\"datePublished\"> March 12, 2013 <\/span> <span class=\"slug-vol\"> vol. 80 <\/span><span class=\"slug-issue\"> no. 11 <\/span><span class=\"slug-pages\"> 1067 <\/span><\/cite><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Array<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[28],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - 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