A 10-Year-Old Boy Is Brought to the Emergency Department Following

question 108

Multiple Choice

A 10-year-old boy is brought to the emergency department following an episode of generalized tonic-clonic seizure.  Intravenous benzodiazepine was administered, terminating the patient's seizure.  He has had no trauma, fever, headache, vomiting, or cough.  For the last 2-3 months, the patient has had muscle pain and cramping that is exacerbated by exercise and relieved after a short rest.  His mother states that for the past year his school performance has been deteriorating.  Physical examination shows a sedated child who is arousable to painful stimuli.  There are no dysmorphic features.  Eye examination reveals pupils that are 3 mm in diameter and briskly reactive to light; bilateral cataracts are seen.  The heart, lungs, and abdomen are normal.  The patient moves all extremities on painful stimulation.  Deep tendon reflexes are 3+ throughout.  Serum calcium is 6 mg/dL, serum albumin is 3.8 g/dL, serum phosphorus is 8.2 mg/dL, and parathyroid hormone level is 150 pg/mL (normal: 10-65) .  A non-contrast CT scan of the head reveals calcification of the basal ganglia.  Which of the following is the most likely cause of this patient's hypocalcemia?

• A)Hyperphosphatemia
• B)Hypoparathyroidism
• C)Primary hyperparathyroidism
• D)Pseudohypoparathyroidism
• E)Vitamin D deficiency

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Definitions:

Posthypnotic Amnesia

A phenomenon where individuals are unable to recall events or information that were experienced while they were in a hypnotic state.

Sociocognitive Theories

Theories that integrate social, cognitive, and behavioral factors to understand learning and personality development.

Sociocognitive Theorists

Researchers or theorists who explore how social and cognitive factors interact to influence human learning and behavior.

Hypnotic Subjects

Individuals who undergo hypnosis and are responsive to suggestions made by the hypnotist.