pot

1. CLINICAL APPROACH TO
HYPOCALCEMIA
DR.RAM JIBAN YADAV
INTERNAL MEDICINE RESIDENT ( FCPS )
CIVIL SERVICE HOSPITAL
MINBHWAN, NEW BANESHWOR ,NEPAL

16. Most common causes

22. PATHOPHYSIOLOGY

25. Clinical Features
The clinical manifestations of hypocalcaemia result from
increased neuromuscular irritability.
 Paraesthesia (tingling sensation) around mouth,
fingers and toes
 Muscle cramps, carpopedal spasms
 Tetany
 Seizures – focal or generalised
 Laryngospasm, stridor and apnoeas (neonates)
 Cardiac rhythm disturbances (prolonged QT interval)
 Chvostek’s and Trousseau’s signs – latent
hypocalcemia
25

29. EFFECT OF HYPOCALCEMIA ON HEART

30. QT INTERVAL
T-WAVE=Ventricular
Repolarisation
QT interval=
ventricular
contraction

44.  Other Drugs In Addition To
Plantinum Agents
 GI Losses
(Diarrhea,vomiting,malabsorpti
on)
 Renal Wasting
 Alcoholism
 Malnutrition
 Perform 24 Hrs Urine &Further
Testing As Apppropriate
 Malabsorption
 Vitmin D Deficiency
 Hypophosphotenia
 GI LOSSES
 LOW DIETARY INTAKE
 LOW SUNKIGHT EXPOSURE
REPLACE VITAMIN D
 AUTOIMMUNE
 GENETICS
 POST SURGICAL
 POST –RADIATION
 INFILTRATIVE DISORDER
 HIV

45. THANK YOU!!