System: Electrolyte Imbalance Condition: Hypo/Hypercalcemia Normal Levels: 8.6 to 10.3 mg/dL
Basic Concept
· Calcium is an important electrolyte in the body.
· The storage of the calcium takes place in the bones
· Amount of calcium in the blood is tightly regulated
· The level of calcium is controlled by Calcitonin and parathyroid hormone.
· Calcium ions play an important role in regulation muscle contraction, enzyme activity, and blood coagulation.
Pathophysiology
· Calcium ions are critical to the signaling when controlling a variety of cellular processes.
· Calcium exists as a free cation, in bound state, and complexed with other ions.
· Calcium signaling pathway indicates the role of the mineral in regulating the enzymes and proteins.
· Calcium function as a signal transducer through the activation of ion channels.
Risk Factors
Hpyo < 8.8 mg/dL · Vitamin D deficiency · Magnesium deficiency · Chronic and acute renal failure · Parathyroid problems · Certain medications Hyper > 10.5 mg/dL
· Hyperparathyroidism
· Some of forms of cancers including cancer of the lung and breast
· Hereditary factors
· Severe dehydration
· Vitamin D over-supplementation
Etiology
Hypo < 8.8 mg/dL · Hypoalbuminemia · Hyperphosphatemia · Medication effects · Vitamin D deficiency Hyper > 10.5 mg/dL
· Overactive parathyroid glands
· 20-30% cancer patients develop hypercalcemia.
· Elevated levels of Vitamin D.
Pathophysiology (Different Types)
· Hypocalcemia develops when the ECF falls below the recommended range
· Hypercalcemia develops when there is a surge or rather an increase in the ECF calcium levels.
· Changes in the calcium levels in the body results in an change in the total calcium in the extracellular matrix.
Clinical Presentation
Hypercalcemia
· CNS effects such as coma, confusion, lethargy
· Renal effects such as polyuria, kidney stones, and renal failure
· Gastrointestinal effects; constipation, anorexia, pancreatitis.
Hypocalcemia
· Neuromuscular symptoms; dysphagia, muscle cramps, numbness
· Neurologic symptoms; irritability, fatigue, seizures
· Dermatologic manifestation; coarse hair, brittle nails, cataracts, poor dentition.
Diagnostic Tests
· Hyperglycemia: Diagnosed using blood tests
· Hypoglycemia: Basic Blood Tests/Metabolic Panel
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