Clinical QuickieEndocrine/Metabolic
Hypercalcemia / Hypocalcemia
Always interpret calcium with albumin — and sometimes ionized calcium.
Total calcium can mislead
Albumin changes alter total calcium without necessarily changing physiologically active ionized calcium.
Hypercalcemia: think PTH vs non-PTH
Primary hyperparathyroidism and malignancy are major branches; medications, vitamin D-related disease and other causes fit underneath.
Hypocalcemia has its own context
Vitamin D deficiency, CKD, hypoparathyroidism, pancreatitis, hypomagnesemia and acute illness can contribute.
Symptoms + ECG change urgency
Neuromuscular irritability, tetany, seizures, arrhythmia or marked symptomatic calcium disturbance requires urgent evaluation.
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