Approach to hypocalcemia (pediatrics) Quiz: Ace Your Exams
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A 17-year-old girl presents to the pediatrician for a well-child visit. Past medical history is significant for celiac disease. She tries to follow a gluten-free diet but occasionally ingests gluten-containing foods. She reports intermittent abdominal pain and diarrhea but does not have systemic symptoms. There is no significant family history. Body mass index (BMI) is in the 45th percentile. Temperature is 37°C (98.6°F), pulse is 92/min, respirations are 16/min, blood pressure is 120/82 mmHg, and oxygen saturation is 100% on room air. On physical examination, the patient is well-appearing. Cardiopulmonary exam is normal, and capillary refill is < 2 seconds. The abdomen is soft, nontender, nondistended, with normoactive bowel sounds. Results of lab work are shown below. In addition to an albumin level, what lab test should be ordered next?
| Laboratory value | Result |
| Complete blood count | |
| Hemoglobin | 12.7 g/dL |
| Hematocrit | 38.1% |
| Leukocyte count | 8,200/mm3 |
| Platelet count | 215,000/mm3 |
| Serum chemistry | |
| Sodium | 137 mEq/L |
| Potassium | 3.5 mEq/L |
| Chloride | 98 mEq/L |
| Bicarbonate | 21 mEq/L |
| Blood urea nitrogen | 16 mg/dL |
| Creatinine | 1.1 mg/dL |
| Glucose | 98 mg/dL |
| Calcium | 7.8 mg/dL |
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