In a patient with hypocalcemia, measurement of serum albumin is essential to distinguish true hypocalcemia, which involves a reduction in ionized serum calcium, from factitious hypocalcemia, meaning decreased total, but not ionized, calcium. To correct for hypoalbuminemia, add 0.8 mg/dL to the total serum calcium for each 1 g/dL decrease in albumin below 4 g/dL.
Symptomatic patients with classic clinical findings of acute hypocalcemia require immediate resuscitation and evaluation. However, most cases of hypocalcemia are discovered by clinical suspicion and appropriate laboratory testing.
The PTH level should be checked as early as possible. Low to normal PTH levels occur in patients with hereditary or acquired hypoparathyroidism and in patients with severe hypomagnesemia. BUN and serum creatinine levels should be measured, because elevated levels may indicate renal dysfunction.
For more on the workup of calcium deficiency, read here.
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Cite this: Romesh Khardori. Fast Five Quiz: Test Yourself on Various Nutritional Deficiencies - Medscape - Apr 10, 2017.