A 22-year-old woman is brought to the emergency department after 30 minutes of rapid, deep breathing that began during an argument. She reports tingling around her mouth and in both hands. She is alert and orientated. Her wrists are flexed with the fingers extended and held together, and the same posture appears in the other hand while a blood pressure cuff is inflated. Results: arterial pH 7.54; arterial carbon dioxide tension 24 mmHg; serum bicarbonate 20 mmol/L; serum potassium 3.3 mmol/L; serum total calcium 2.34 mmol/L; serum albumin 44 g/L; serum magnesium 0.85 mmol/L.
Which one of the following best accounts for the spasm in this woman's hands?
Keep going — a set of ten like this one, one at a time.
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