This individual is suffering from hypocalcemia, which explains the seizures, twitching (reason for Chvostek sign - tapping of the facial nerve causing contraction of the muscles), and spasms (similar to Trousseau sign - inflation of the blood pressure cuff causing carpal spasm). It also may present with QT prolongation and numbness and tingling (as described). It is also important to note that though mild hypocalcemia causes hyporeflexia, extreme hypocalcemia can lead to hyperreflexia, tetany, parasthesias, and seizures (see here). Basically you cannot bank on the reflexes.
Hypercalcemia would present with stones (renal), bones(pain), groans(abdominal pain), thrones( urinary frequency), psychiatric overtones(anxiety, altered mental status).
The others answers are incorrect because:
Bicarbonate disturbances are related to acid/base imbalance and would not present with the symptoms described.
Chloride:
Hypochloremia (associated with excessive vomiting) is typically accompanied by hyponatremia and typically presents with weakness/fatigue and dehydration.
Hyperchloremia disturbances are generally related to kidney issues and when signs present they are dehydration, excessive thirst, fatigue, and dry mucus membranes
Potassium:
Hypokalemia presents with muscle cramps, spasm, and weakness but also with cardiac anomalies (arrhythmias) and flattened T-waves on ECG.
Hyperkalemia presents with wide QRS and peaked T waves on ECG, weakness, and arrhythmias.
Sodium:
Hyponatremia can cause seizures and stupor, but it also typically presents with nausea and vomiting, weakness/fatigue, and confusion. Here is a good hyponatremia pneumonic (SALTLOSS - Stupor, Anorexia[nausea, vomiting], Lethargy, Tendon reflexes decreased, Limp muscles/weakness, Orthostatic hypotension, Seizures, Headache)
Hypernatremia presents with irritability and stupor
submitted by โcassdawg(1780)
This individual is suffering from hypocalcemia, which explains the seizures, twitching (reason for Chvostek sign - tapping of the facial nerve causing contraction of the muscles), and spasms (similar to Trousseau sign - inflation of the blood pressure cuff causing carpal spasm). It also may present with QT prolongation and numbness and tingling (as described). It is also important to note that though mild hypocalcemia causes hyporeflexia, extreme hypocalcemia can lead to hyperreflexia, tetany, parasthesias, and seizures (see here). Basically you cannot bank on the reflexes.
Hypercalcemia would present with stones (renal), bones(pain), groans(abdominal pain), thrones( urinary frequency), psychiatric overtones(anxiety, altered mental status).
The others answers are incorrect because:
Electrolyte Disturbances: FA2020 p591