Which of the following is associated with a sudden decrease in serum calcium levels?

Manifestations of acute hypocalcemia includes increased neuromuscular excitability and cardiovascular effects of a decrease in ionized calcium. Nerves exposed to low ionized calcium, levels shows decreased threshold for excitation, repetitive responses to a single stimulus and in extreme cases continuous activity. Increased neuromuscular excitability manifest as paresthesias and tetany. In severe cases laryngeal spasm, seizures and death can occur. Ref: Poh Pathophysiology: Concepts of Altered Health States By Ruth A. Hannon, Page 762