Hypocalcemia Cramps, carpopedal (hypoparathyroidism) spasms, paresthesias, lethargy, apathy, convulsions, hypotension Diabetes insipidus Plasma calcium, phosphate, alkaline phosphatase 10% calcium gluconate mL/kg IV over 15 Polyuria, polydipsia, Paired plasma and urine Central : IV fluids dehydration, osmolality and at two-thirds irritability, fever, sodium maintenance rate drowsiness, coma plus replete deficit over 48 hrs; vasopressin 1–10 mU/kg/hr IV Nephrogenic : IV fluids at urine output plus replete deficit over 48 hrs Syndrome of Anorexia, headache, Paired plasma and urine Seizures : 3% inappropriate nausea, vomiting, osmolality and saline at 1–3 antidiuretic hormone irritability, sodium mL/kg IV; secretion seizures, coma furosemide mg/kg IV stat; benzodiazepines Otherwise : fluid restriction Thyroid storm Goiter, Free T4 , Total T3, TSH Propranolol 10 exophthalmos, μg/kg IV over high fever, 15 min; Lugol tachycardia, iodine 9–15 congestive cardiac drops/day failure, delirium, orally; stupor methimazole 20–30 mg q6– 12h (initially); tepid sponging Neonatal thyrotoxicosis Goiter, failure to Free T4 , Total T3, TSH Propranolol gain weight, mg/kg tid orally; irritability, potassium tachycardia, iodide two drops congestive cardiac bid orally; failure methimazole