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Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Calcium, Phosphate, and Magnesium
Page: 1

Question 1# Print Question

A 32-year-old G2P1 female at 34 weeks gestation and a history of chronic kidney disease develops hypertension and altered mental status followed by seizures. She is started on intravenous magnesium with seizure resolution. She becomes somnolent 3 hours later, and physical examination reveals hyporeflexia.

What is the immediate management for this symptom?

A. Hypotonic IV fluids
B. Calcium gluconate infusion
C. Hemodialysis
D. Furosemide

Question 2# Print Question

A 66-year-old homeless man presents to the emergency department with severe weakness for last few weeks. His vitals are as follows:

  • Temperature 36.9°C
  • HR 70 beats/min
  • RR 22 breaths/min
  • oxygen saturation 94% on room air

He is alert and oriented to time and person. The patient denies any specific complaints besides back pain for several days. Routine chest radiograph and ECG are performed:

These ECG changes are most likely explained by:


A. Cold exposure
B. Hyperthyroidism
C. Hypercalcemia
D. Acute coronary syndrome

Question 3# Print Question

A 65-year-old male nursing home resident with a history of quadriplegia is admitted to the ICU for respiratory failure. He is intubated and sedated. Tube feeds are initiated. Electrolyte levels are as follows:

  • Serum calcium—7.0 mg/dL
  • Serum phosphorus—0.9 mg/dL
  • Serum magnesium—1.6 mg/dL
  • Serum potassium—3.6 mg/dL
  • Serum sodium—138 mg/dL

What replacement strategy should be initiated for this patient?

A. IV Calcium followed IV Phosphorus
B. IV phosphorus followed by IV calcium
C. IV calcium followed by oral phosphorus replacement
D. Oral phosphorus replacement only

Question 4# Print Question

A 65-year-old male with a history of end-stage renal disease on hemodialysis presents to the emergency room with history of fever for the last few days. Vitals are as follows:

  • Bp 130/70 mm Hg
  • RR 20 breaths/min
  • Temp 36.6°C
  • HR 78 beats/min

Lap values are notable for parathyroid hormone (PTH) 350 pg/mL and calcium 12 mg/dL.

Physical examination reveals the following skin lesions:

Which of the following is the most appropriate first-line pharmacological therapy for this patient?

A. Antibiotics
B. Sodium thiosulphate infusion
C. Sodium thiosulphate infusion and cinacalcet
D. Treat with analgesics till surgical parathyroidectomy

Question 5# Print Question

A 67-year-old male is admitted to the trauma ICU for management of anaphylaxis. He is intubated for airway swelling. 3 hours from the onset of symptoms the patient is hemodynamically stable without a pressor requirement. Routine labs ordered show the following: 

  • Calcium: 8.0 mEq/L
  • Ionized calcium: 1.03 mEq/L
  • Sodium: 136 mg/dL
  • Potassium: 4.0 mEq/L

Which of the following electrolytes require repletion?

A. Potassium, magnesium, and IV calcium
B. Potassium only
C. Neither potassium or IV calcium
D. Potassium and magnesium

Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Calcium, Phosphate, and Magnesium
Page: 1 of 2