امرأة عمرها ٥٢ سنة بعد استئصال الغدد جارات الدرقية بسبب ورم، في اليوم الثاني صارت عندها تقلصات عضلية وتنميل شديد، ثم تشنج في الحنجرة مع صرير. الكالسيوم ٦٫٤. ما أول إجراء؟

A 52-year-old woman on day 2 after parathyroidectomy for an adenoma develops muscle cramps and severe tingling, then laryngospasm with stridor. Calcium is 6.4. What is the first action?

1. Immediate IV calcium as ordered with airway support
2. Oral calcium and repeat the test tomorrow morning
3. An IV sedative to treat the anxiety and cramps
4. A diuretic to reduce neck swelling

Answer: A) Immediate IV calcium as ordered with airway support. Severe hypocalcaemia can cause laryngospasm, seizures and arrhythmia and needs immediate IV calcium gluconate with cardiac monitoring.