q1 - raj000

[ArchivalUser]

A 40-year-old man has an anxiety attack prior to boarding an airplane for his first plane trip. His hyperventilates and has to be helped to avoid fainting. While sitting, he develops a burning around his mouth and he adducts his thumbs into his palms. What serum calcium finding is most likely for this patient?

Click on the circle next to your answer choice
A. Decreased ionized calcium
B. Decreased total calcium
C. Increased ionized calcium
D. Increased total calcium

[ArchivalUser]

ionized Ca is the active form, guess A?

[ArchivalUser]

anxiety-->hyperventilation-->alkalosis-->incresed negative charge on albumin-->binds to free calcium-->decres in amt of ionized calcium-->signs of hypocalcemia n tetany-->perioral perasthesias n tetany

[ArchivalUser]

the answer is A.
What happened here is that hyperventilation due to anxiety ususally causes increase in calciumbinding globulin and this will bind more calcium leading to decreased ionised calcium which is the active form so giving the pt signs of hypocalcemia.

[ArchivalUser]

A.

[ArchivalUser]

A A

[ArchivalUser]

definitely, A!
reduced extracellular ionized calcium producing tetany.
characteristic of tetany: carpopedal spasm (wrist flexion or at metacarpophalangeal joint, as in extended digits) or Chvostek's sign (brisk facial muscle contraction whenever you tap over the facial muscle.