Approach to hypocalcemia (pediatrics) Quiz: Ace Your Exams
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A 9-month-old boy in status epilepticus is brought to the emergency room by ambulance. Intravenous (IV) access was obtained by the paramedics, and he was given two doses of IV lorazepam but continues to seize. His parents state he has not had any fevers, upper respiratory infections, trauma, or potential overdose. He was born at 39 weeks of gestation, and the pregnancy and delivery were uncomplicated. He has been growing well but has gross motor delays for which he is getting physical therapy. The parents report that he is otherwise healthy. Temperature is 37.6°C (99.7°F), pulse is 165/min, respirations are 42/min, blood pressure is 85/48 mmHg, and oxygen saturation is 96% on room air. On physical examination, the patient is in status epilepticus with tonic-clonic movements. There is noticeable frontal bossing and bowing of the legs. Additional physical examination is difficult to perform. The patient is placed on continuous monitoring, and he is provided supplemental oxygen. Results of lab work are shown below. Which of the following should be administered to this patient to treat the underlying cause of the seizures?
| Laboratory value | Result |
| Complete blood count | |
| Hemoglobin | 12 g/dL |
| Hematocrit | 40 % |
| Leukocyte count | 14,300 /mm3 |
| Platelet count | 317,000/mm3 |
| Serum chemistry | |
| Sodium | 142 mEq/L |
| Potassium | 4.6 mEq/L |
| Glucose | 78 mg/dL |
| Calcium | 6.8 mg/dL |
| Toxicology | |
| Urine toxicology | Negative |
| Serum toxicology | Negative |
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