Patient’s Clinical Presentation

A 50-year-old male had a total thyroidectomy followed by thyroid hormone-replacement therapy. Thirty-six hours later he developed laryngeal spasms, a mild tetany, and cramps in the muscles of the hands and arms. The following tests were performed:

Urine calcium 20 mg/dL

Urine phosphorus 0.1 g/day

Plasma calcium 7.0 mg/dL

Plasma phosphorus 5.0 mg/dL

Calcium gluconate and vitamin D (calcitriol) were given orally each day and the tetany and laryngeal spasms were alleviated.

Provide detailed and thorough responses to the questions below based on the clinical information presented above.

1. What endocrine disorder is present in this person?

2. What is the purpose of vitamin D administration with the calcium?

3. What caused the tetany and laryngeal spasms?

4. How is blood calcium normally maintained at its physiological level?