Calcium and Parathyroid USMLE Step 1 Practice Question
A 19-year-old woman with no significant past medical history presents with seizures and tetany. Vital signs show BP 118/76 mmHg, HR 102/min, RR 20/min, temperature 37.2°C. Laboratory studies reveal calcium 5.8 mg/dL, phosphate 7.2 mg/dL, magnesium 1.2 mg/dL, and PTH 8 pg/mL. Serum albumin is normal. She denies recent neck surgery or radiation. Which of the following is the most appropriate initial management?
Answer choices
- AIntravenous calcium gluconate to rapidly raise serum calcium and prevent further seizuresCorrect answer
- BPTH replacement therapy with recombinant PTH analog
- COral calcium supplementation with careful dosing titration over days
- DMagnesium supplementation alone, delaying calcium repletion
- EPhosphate binders to reduce serum phosphate before calcium supplementation
- FVitamin D supplementation with cholecalciferol to increase intestinal calcium absorption
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