Diagnostic Highlights continued

Abnormality with

Test Normal Result Condition Explanation levels are reported as high or low, calculate the actual level of calcium by the following formula: Corrected total calcium (mg/dL) = (measured total calcium mg/dL) + 0.8 (4.4-measured albumin g/dL)

Ionized calcium is approximately 46%-50% of circulating calcium and is the form of calcium available for enzymatic reactions and neuromuscular function; levels increase and decrease with blood pH levels; for every 0.1 pH decrease, ionized calcium increases 1.5%-2.5%.

Other Tests: Electrocardiogram (prolonged QT Interval; In patients taking digitalis preparations, hypocalcemia potentiates digitalis toxicity), phosphorus (elevated in hypocalcemia resulting from most causes, though in hypocalcemia from vitamin D deficiency, it is usually low), magnesium, creatinine, urine calcium. Note that alkalosis augments calcium binding to albumin and increases the severity of symptoms of hypocalcemia.

Serum ionized calcium: unbound calcium; level unaffected by albumin level

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