Calcium Metabolism in Emergency Medicine

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Question 1 of 10

1. Question
Which of the following substances affect serum calcium?
- Plasma pH
- Plasma albumin levels
- Parathyroid hormone
- Magnesium
- Aspirin
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Question 2 of 10

2. Question
Which of the following conditions cause hypercalcaemia?
- Malignancy
- Pseudohypoparathyroidism
- Thiazide diuretics
- Thyrotoxicosis
- Chronic lithium therapy
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Question 3 of 10

3. Question
Calcium is used in all tissues of the body, therefore the effects of disturbed calcium metabolism are widespread.

Hypercalcaemia has various effects on the ECG.

Which of the following effects occur?
- QT interval lengthening
- Bradycardia
- J wave
- Broadened T wave
- First degree AV block
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Question 4 of 10

4. Question
Which of the following statements regarding the management of hypercalcaemia are true?
- Mild asymptomatic elevations of calcium found on routine screening can be investigated as an outpatient
- In the setting of hypercalcaemia, digoxin therapy should be stopped and replaced with an alternative agent
- Diuretic therapy must be commenced immediately
- Dialysis should be considered earlier in the management of end stage renal failure
- Hypokalaemia and hypercalcaemia commonly coexist
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Question 5 of 10

5. Question
Which one of the following conditions are associated with the development of tetany?
- Chvostek’s sign
- Trousseau’s sign
- Persistent vomiting
- Hypoventilation
- Primary hyperaldosteronism
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Question 6 of 10

6. Question
Which of the following statements is the best and most correct answer regarding the treatment of hypocalcaemia in the emergency department?
- Calcium salts can be given intravenously when required
- Hypocalcaemia relies on the measurement of free ionised plasma fraction of calcium
- Hypocalcaemia exists when the serum calcium level is below 3mmol/l
- Initially, calcium salts should always be administered orally
- Hypophosphataemia which is common in alcoholics and diabetic keto acidosis (dka) leads to hypocalcaemia
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Question 7 of 10

7. Question
A patient’s albumin is 28g/l and the measured calcium is 1.82mmol/l.

Which is the corrected calcium value?
- 2.61mmol/kg
- 2.20mmol/l
- 1mmol/l
- 2.26mmol/l
- 2.06mmol/l
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Question 8 of 10

8. Question
Which of the following measurements correctly fit the clinical diagnosis?
- Paget’s disease: Ca ↓ PO4 normal; ALP ↑
- Primary hyperparathyroidism: Ca ↑ PO4 ↓ ALP normal
- Osteoporosis: Ca ↑ PO4 normal; ALP normal
- Hypoparathyroidism: Ca ↑ PO4 ↑ ALP normal
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Question 9 of 10

9. Question
The acute management of hypercalcaemia is a medical emergency. Which of the following agents are used?
- Pamidronate
- IV bisphosphonates
- IV phosphate
- Prednisolone/hydrocortisone
- Calcitonin
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Question 10 of 10

10. Question
A variety of disorders of calcium balance are listed with their associations.

Which one of the following disorders (on the left) is correctly alongside its association?
- Hypoparathyroidism – hypercalcaemia
- Osteomalacia – bony cysts
- Osteoporosis – extremely high elevation of ALP and PTH
- Paget’s disease of bone – lytic bony lesions followed by mainly sclerotic new bone expansion with trabecular thickening
Correct

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