Postoperative hypocalcemia managementDownloads

A 48-year-old woman underwent a thyroidectomy with central neck dissection due to papillary thyroid carcinoma. On day 2 postoperatively, she developed irritability, dysphagia, difficulty breathing, and spasms in different muscle groups in her upper and lower extremities. The vital signs include blood pressure 102/65 mm Hg, heart rate 93/min, respiratory rate 17/min, and temperature 36.1℃ (97.0℉). Physical examination shows several petechiae on her forearms, muscle twitching in her upper and lower extremities, expiratory wheezes on lung auscultation, decreased S1 and S2 and the presence of an S3 on cardiac auscultation, and positive Trousseau and Chvostek signs. Laboratory studies show: Ca2+ 4.4 mg/dL Mg2+ 1.7 mEq/L Na+ 140 mEq/L K+ 4.3 mEq/L Cl- 107 mEq/L HCO3- 25 mEq/L Administration of which of the following agents could prevent the patient’s condition?

A 45-year-old woman presents to her primary care provider complaining of daytime drowsiness and fatigue. She reports that she can manage at most a couple of hours of work before needing a nap. She has also noted impaired memory and a 6.8 kg (15 lb) weight gain. She denies shortness of breath, chest pain, lightheadedness, or blood in her stool. At the doctor’s office, the vital signs include: pulse 58/min, blood pressure 104/68 mm Hg, and oxygen saturation 99% on room air. The physical exam is notable only for slightly dry skin. The complete blood count (CBC) is within normal limits. Which of the following is a likely additional finding in this patient?