Endocrine System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This patient has presented with a first-episode tonic-clonic seizure at age 32, a highly concerning presentation.\n\nFurther questioning reveals a history of episodic, abnormal twitching of his facial muscles during the preceding weeks, while examination reveals positive Trousseau\u0027s and Chvostek\u0027s signs; considered together, these findings are strongly suspicious of hypocalcemia.\n\nThus, an ionized calcium assay is a good next step; this should be obtained in parallel with investigations to rule out other common causes of seizures, i.e. serum glucose levels, a serum electrolyte panel, a complete blood count, and non-contrast computed tomography (CT) of the brain.\n\nThe investigation results confirm the presence of hypocalcemia; given the absenc"}]}

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