Q:

How to measure serum calcium?

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A 54-year-old female presents with drowsiness to the emergency. Her BP is 140/90 mm of Hg with pulse after rate 100/minute. Her investigations reveals serum creatinine 2.4 mg/dL, Na 140 mEq/L, K 4.3 mEq/L. Complete blood count (CBC) and liver function test (LFT) is normal. CT scan head is normal. Her past evaluation reveals a cervical lymph node fine needle aspiration cytology (FNAC) suggestive of granulomatous inflammation. Her bone marrow examination is suggestive of non-Hodgkin’s lymphoma.

How to measure serum calcium?

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Serum calcium should be measured in fasting state. Acidosis decreases the association of calcium with protein. Correction of serum calcium is 0.8 times the deficit in serum albumin in g/dL or 0.5 times the deficit in serum globulin in g/dL. Percentage protein bound calcium = [0.8 × albumin (g/L)] + [0.2 × globulin (g/L)] + 3 Corrected calcium level (mg%) = serum calcium (mg%) + [4 – serum albumin (g%) × 0.8]

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