Clinical Significance of Calcium Homeostasis

(TBL)

Group 3
Amnah Alnashri - Khadijah Alhadi- Ameera Alzubaidi - Atheer Alrashdi -
Sharifa Alsohabi– Daniah Bahshowan- Salma Mohammed - Zahra
Alrahmani - Ebtisam Alsayed - Fatima mohammed alnashri - Fatimah
Aljapri - Areej bajbyr – noor sabi – ghadi alqarni - Atheerothman - Roaa
Ali Bajned –wodyan mohammed

Case 3
A 32-year-old woman presented to the ER with complaints of
involuntary painful hand spasms lasted several minutes, resolving
spontaneously. She states that as she worked folding the laundry, she
had a sudden severe spasm of her right hand such that her fingers
flexed.
She has past medical history of thyroid tumor status post-
thyroidectomy 3 years ago.
She is taking thyroid hormone replacement therapy and a prenatal
multivitamin.
On physical examination, she has positive Chvostek and Trousseau
signs. Examination is otherwise unremarkable.
Serum calcium level = 7 mg/dl( ↓↓) .

1. What are the key symptoms and signs that could help you to reach your
diagnosis?
2. What other symptoms you would like to ask about?

3. What is your diagnosis ?

Hypocalcemia due to acquired hypoparathyroidism

4. What is the suspected cause for her condition ?

She has a past medical history of a thyroid tumor and undergoes
thyroidectomy 3 years ago, so the most common cause we expect is an
injury to or removal of parathyroid glands that can accidentally happen
during surgery to remove the thyroid

5. What are the expected serum levels of calcium & phosphorus in 1ry and
2ry Hyperparathyroidism and in hypoparathyroidism?

Didnosis Calcium Phosphate

Reference range ( 8.5- Reference range( 2,5-4.5
10,5 mg/dl) mg/dl)
1ry Hyperparathyroidism high Low N or low
2ryHyperparathyroidism low or low N high
Hypoparathyroidism low high