Electrolyte Disorders (Calcium, Magnesium, Phosphate) — DCE Clinical Case

Calcium-focused history — what you must establish

• The symptom pattern: perioral and digital paraesthesia, cramps, carpopedal spasm episodes, and red-flag neurological symptoms — stridor, seizures, syncope or palpitations (long QT) — plus their temporal relationship to the surgery ^[2].
• The surgical and endocrine context: indication for thyroidectomy, final histology (any parathyroid tissue in the specimen), voice change since surgery (recurrent laryngeal nerve), and whether calcium and PTH were ever checked post-operatively ^[2].
• The modifiers: current calcium/vitamin D therapy and adherence, PPI or diuretic use, alcohol, bowel symptoms suggesting malabsorption, menstrual and fracture history (chronic hypocalcaemia and vitamin D deficiency both speak to bone) ^{[4] [5]}.
• The impact: work, driving (seizure and arrhythmia safety), mood and cognition — the quality-of-life burden of hypoparathyroidism is part of the assessment, not a soft extra ^[3].