A 42-year-old woman undergoes total thyroidectomy for multinodular goitre. On postoperative day 1 she develops circumoral tingling, carpopedal spasm, and a positive Trousseau's sign. Serum corrected calcium is 7.2 mg/dL. The most immediate management is:

• A Oral calcium carbonate 1 g TDS
• B Magnesium sulphate infusion
• C Intramuscular PTH injection
• D Intravenous calcium gluconate 10% 10 mL over 10 minutes ✓

Explanation

Symptomatic hypocalcaemia (tetany, Trousseau's sign) post-thyroidectomy is a surgical emergency requiring immediate intravenous calcium gluconate 10% (10 mL IV over 10 minutes), which rapidly corrects neuromuscular excitability. Oral calcium is appropriate only for asymptomatic or mild hypocalcaemia without tetany.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.