A 38-year-old female presents with tingling in her hands and feet, muscle cramps, and a positive Chvostek sign following total thyroidectomy. What electrolyte disturbance is responsible?
Answer and explanation
Correct answer: B. Hypocalcemia
- Step 1: Inadvertent removal or devascularization of the parathyroid glands during thyroidectomy leads to acute hypoparathyroidism.
- Step 2: This causes hypocalcemia, presenting with neuromuscular irritability, tetany, perioral paresthesia, and facial twitching upon tapping the facial nerve (Chvostek sign).
Answer
Hypocalcemia.
Why not the others: 'Hypercalcemia' causes lethargy, confusion, constipation, and shortened QT interval ('bones, stones, groans'); 'Hypomagnesemia' can cause hypocalcemia secondary to impaired PTH release but is not the primary surgical outcome; 'Hyperkalemia' causes cardiac arrhythmias and muscle weakness.
Practise more Internal Medicine, Cardiology and Pulmonology.
Free questions with an explanation for every one, and full timed National Health Regulatory Authority Licensure Examination (NHRA Bahrain) mock tests.
More Internal Medicine, Cardiology and Pulmonology questions
- A 58-year-old male presents with crushing substernal chest pain radiating to his left jaw for 45 minutes. His ECG reveals 3 mm ST-segment el…
- A 64-year-old female with long-standing hypertension presents with sudden dyspnea and orthopnea. Examination reveals bilateral basilar crack…
- A 42-year-old female presents with fatigue, cold intolerance, weight gain, and constipation. Laboratory evaluation reveals an elevated TSH o…
- A 68-year-old male with a 40 pack-year smoking history presents with progressive dyspnea and chronic morning cough. Spirometry demonstrates…
- A 32-year-old male presents with acute severe headache, neck stiffness, and fever of 39.1 degrees C. Physical examination demonstrates a pos…
- A 52-year-old male with type 2 diabetes presents for routine follow-up. Blood pressure is 148/92 mmHg on two separate visits. Urinalysis dem…