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4th April 2024
A 35-year-old female who underwent a thyroidectomy for a large thyroid goitre 2 days ago presents to the emergency department.
A 35-year-old female who underwent a thyroidectomy for a large thyroid goitre 2 days ago presents to the emergency department. She is complaining of painful facial spasms and perioral tingling. Whilst taking her blood pressure, the nurse comments that her arm became stiff and bent at the wrist and elbow. Whilst in the department, she suddenly experiences a generalised tonic-clonic seizure that self-terminates after 2 minutes, with marked postictal drowsiness. Blood tests reveal the following:
| Result | Reference Range | |
|---|---|---|
| Na | 136 mmol/L | 135-145 mmol/L |
| K | 4.1 mmol/L | 3.5-5.0 mmol/l |
| eGFR | >90 ml/min/1.73m² | >90 ml/min/1.73m² |
| AdjCa | 1.88 mmol/L | 2.1-2.6 mmol/L |
| Phosphate | 1.78 mmol/L | 0.8-1.4 mmol/L |
| PTH | 0.3 pmol/L | 0.9-5.4 pmol/L |
After initial stabilisation of the patient, what is the most important next step in managing this patient?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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