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Symptomatic hypocalcaemia — RACP Paediatrics MCQ

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ModerateEmergencySymptomatic hypocalcaemiaRACP Paediatrics

A 10-year-old is post-thyroidectomy and develops perioral tingling, carpopedal spasm, and a positive Chvostek sign. Serum calcium is 1.6 mmol/L. Phosphate is elevated. PTH is undetectable. What is the most appropriate immediate treatment?

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Correct answer: B — IV calcium gluconate

Symptomatic hypocalcaemia (carpopedal spasm, Chvostek/Trousseau signs, seizures) requires immediate IV calcium gluconate 10% (0.5 mL/kg over 10 minutes with cardiac monitoring, max 20 mL). This is followed by a continuous calcium infusion. Post-thyroidectomy hypoparathyroidism is managed long-term with oral calcium and calcitriol.

Reference: RCH Melbourne – 2023 – Hypocalcaemia CPG; RACP Paediatric Curriculum – Emergency/Endocrine