Wednesday, June 26, 2019

Hypocalcaemia in patient occur if the level of calcium is.. 7.5



Hypocalcaemia in patient occur if the level of calcium is:
a. 16
b. 12
c. 10
d. 7.5***

Hypocalcemia is usually due to insufficient levels of parathyroid hormone or vitamin D or resistance to these hormones. The treatment consists mainly of oral calcium and vitamin D supplements, as well as magnesium if there is a deficiency. Further treatment with thiazide diuretics, phosphorus chelators and a low salt and phosphorus diet can be further increased when hypocalcemia secondary to hypoparathyroidism is treated. Acute and life-threatening calcium deficiency requires treatment with intravenous calcium. Current treatment recommendations are largely based on the opinion of clinical experts and published case reports, as there is not enough evidence available from controlled clinical trials. Complications of current therapies include hypercalciuria, nephrocalcinosis, renal failure, and soft tissue calcification. Current therapy is limited by fluctuations in serum calcium. Although these complications are well recognized, the effects on overall well-being, mood, cognitive function and quality of life, as well as the risk of complications, have not been adequately studied.
Family physicians play a central role in educating patients about the long-term management and complications of hypocalcemia. At present, management is suboptimal and marked by fluctuations in serum calcium and the absence of parathyroid hormone replacement therapy approved for hypoparathyroidism.
Hypocalcemia is a common biochemical abnormality that varies in severity, ranging from no symptoms in mild cases to an acute life-threatening attack1. Serum calcium levels are regulated within a narrow range (2.1-2.6 mmol / l) by 3 major calcium-regulating hormones, including parathyroid hormone (PTH), vitamin D and calcitonin, through their specific effects on the intestines, kidneys and skeleton1,2. About half of the total serum calcium is protein bound and the remaining free ionized calcium is physiologically active2. Serum calcium levels should be adjusted for albumin level before confirming a diagnosis of hypercalcemia or hypocalcemia1.
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Some causes of hypocalcemia:
- Vitamin D deficiency or vitamin D resistance
- Hypoparathyroidism following surgery.
- Hypoparathyroidism due to autoimmune disease or genetic causes.
- Nephropathy or terminal liver disease causing vitamin D insufficiency
- Pseudohypoparathyroidism or pseudopseudohypoparathyroidism.
- Infiltration of metastases or heavy metals (copper, iron) of the parathyroid.
- Hypomagnesemia or hypermagnesemia.
- Sclerotic metastases.
- Postparathyroidectomy bone greed syndrome.
- Phosphate gold infusion or citrated blood transfusions.
- Serious illness.
- Drugs (eg, high-dose bisphosphonates intravenously).
- Fanconi syndrome.
- Anterior radiation of the parathyroid glands.