Endocrine drugs: post-thyroidectomy hypocalcaemia: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Endocrine drugs: post-thyroidectomy hypocalcaemia

Sample item

On day 2 after total thyroidectomy a woman has perioral tingling, carpopedal spasm and a positive Chvostek sign. Serum calcium is 1.6 mmol/L and the ECG shows a long QT interval. Which drug should be given immediately?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Intravenous calcium gluconate

Symptomatic hypocalcaemia from parathyroid injury is an emergency treated with slow intravenous calcium gluconate under ECG monitoring. Oral calcium and calcitriol follow for maintenance.

Option by option

  • A. Oral cinacalcet with meals

    Cinacalcet lowers PTH and calcium, which would worsen the problem.

  • B. Oral vitamin D alone, daily

    Oral vitamin D alone acts too slowly for tetany with QT prolongation.

  • C. Subcutaneous calcitonin injection

    Calcitonin lowers serum calcium and would worsen tetany.

  • D. Intravenous calcium gluconate (correct)

    Correct. Intravenous calcium gluconate corrects symptomatic hypocalcaemia quickly.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Intravenous calcium gluconate. Symptomatic hypocalcaemia from parathyroid injury is an emergency treated with slow intravenous calcium gluconate under ECG monitoring.

Why is "Oral cinacalcet with meals" not the answer?

Cinacalcet lowers PTH and calcium, which would worsen the problem.

Why is "Oral vitamin D alone, daily" not the answer?

Oral vitamin D alone acts too slowly for tetany with QT prolongation.

Why is "Subcutaneous calcitonin injection" not the answer?

Calcitonin lowers serum calcium and would worsen tetany.

What concept does this question test?

It tests Endocrine drugs: post-thyroidectomy hypocalcaemia in Pharmacology. Oral calcium and calcitriol follow for maintenance.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Endocrine drugs: post-thyroidectomy hypocalcaemia?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.