HYPOCALCEMIA.pptx ram jiban yadav civil service Nepal

ppt

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

2. Most common causes

3. PATHOPHYSIOLOGY

4. 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

5. EFFECT OF HYPOCALCEMIA ON HEART

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

7. Other Drugs In Addition To Plantinum Agents GI Losses ( Diarrhea,vomiting,malabsorption ) 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

8. THANK YOU!!