TUTORQuestion 1 of 5· MedicineECGLab table
A 36-year-old woman presents two days after total thyroidectomy with perioral tingling and painful carpopedal spasm.
She is alert, her blood pressure is 126/74 mmHg and she has no stridor or active bleeding.
An ECG is shown below.
Figure 1.
| Test | Result | Reference range |
|---|---|---|
| Corrected calcium | 1.72 mmol/L | 2.15–2.55 mmol/L |
| Magnesium | 0.78 mmol/L | 0.70–1.10 mmol/L |
The ECG demonstrates sinus rhythm with marked QT-interval prolongation and no ST-segment elevation.
What is the most appropriate immediate treatment?
Correct answer: C
Symptomatic severe hypocalcaemia with tetany and QT prolongation requires monitored intravenous calcium gluconate. Oral calcium is too slow for initial stabilisation, and intramuscular calcium is unsafe because of tissue injury. Ongoing calcium and active vitamin D replacement may be required after the acute symptoms are controlled.
Pick an answer to reveal the explanation.
