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Hypocalcaemia
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> ''Sx'' - numbness, paraesthesia, muscle cramps, convulsions, cataracts, parkinsonism (basal ganglia calcification) trousseaus (compress upper arm and hand spasm) and chvostek's sign, papilloedema ''Ix'' PO3, alk phos, Cr, Mg, vit D and PTH levels need checking if low Ca (check if put in wrong tube - EDTA ...) Note - HypoCa gives long QT interval on ECG ''Causes'' //Vitamin D deficiency// - little sun, diet (beware chapati - high phytate binds Ca preventing absorption), malabsorption, //renal failure//, anticonvulsants PTH deficiency - hypoparathryriod, hypoMg, parathroidectomy PTH resistance - hypoMg, pseudohypoparathryoid artefactual - if put in EDTA tube Other - pancreatitis, high PO3 intake, rhabdomyolysis, hungry bone syndrome ''Vitamin D deficiency'' low Ca PO3 and high alk phos (but may all be normal) raised PTH (attempting to raise Ca) Carbamazepine clears vit D more quickly as potentiates hepatic enzymes Vit D - mostly from UVB on dermis (less effective if pigmented skin), diet - oily fish, egg yolk (insufficient for full requirement) measure 25OHD - >50 OK, 30-50 ?? <30 deficient treat with oral vitD3 - load then maintain, daily or intermittently ''Coeliac'' - think with other autoimmune low Ca from malabsorption leading to rickets / osteomalaccia ''Osteomalaccia'' - raised alk phos, hypoCa, hypo PO3
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Calcium