Evaluation of hypocalcemia

When there is clinical suspicion of hypocalcemia, an ionized calcium level is mandatory. In the presence of acute life-threatening symptoms, intravenous calcium chloride is recommended. After normalization of ionized calcium, a search for the underlying causes should begin. History and physical examination should alert the physician to various medications and associated medical illnesses that may be responsible. In the event that this is unrevealing, measurements of serum magnesium, PTH, and phosphorus may be helpful in evaluating the causes of hypocalcemia.

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