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Post-surgical hypoparathyroidism — SCE Endocrinology MCQ

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EasyCalcium/BonePost-surgical hypoparathyroidismSCE Endocrinology

A 46-year-old woman has tingling, carpopedal spasm and seizures after total thyroidectomy. Calcium is 1.72 mmol/L, phosphate is high and PTH is undetectable. What is the most appropriate management?

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Correct answer: A — Intravenous calcium gluconate followed by activated vitamin D and oral calcium

Symptomatic acute hypocalcaemia after thyroid surgery requires intravenous calcium, then oral calcium and activated vitamin D. Bisphosphonates and cinacalcet lower calcium and would worsen symptoms. High phosphate with low PTH supports hypoparathyroidism.

Reference: Society for Endocrinology Hypocalcaemia Guidance; BNF