thyroidectomy

[dr_maria]

A 23-year-old woman undergoes total thyroidectomy for carcinoma
of the thyroid gland. On the second postoperative day, she
begins to complain of tingling sensation in her hands. She appears
quite anxious and later complains of muscle cramps. Initial therapy should consist of:

a. 10 mL of 10% magnesium sulfate intravenously.
b. Oral vitamin D.
c. 100 μg of oral Synthroid.
d. Continuous infusion of calcium gluconate.
e. Oral calcium gluconate.

[dr_maria]

Answer:
d. Continuous infusion of calcium gluconate

If hypocalcemia persists, oral therapy is then added with calcium gluconate. Vitamin D preparations are only used if hypocalcemia is prolonged and permanent hypocalcemia is suspected.
There is no role for thyroid hormone replacement or magnesium sulfate in the treatment of hypocalcemia.