Thyroid: hypocalcaemia: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Thyroid: hypocalcaemia

Sample item

On the second day after total thyroidectomy for a multinodular goitre, a woman has perioral tingling and carpopedal spasm. Serum calcium is 6.8 mg/dL. What is the immediate treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Intravenous calcium gluconate

Transient hypoparathyroidism after thyroidectomy follows devascularisation or removal of parathyroid glands and typically presents at 24 to 72 hours. Symptomatic hypocalcaemia is an emergency treated with intravenous calcium gluconate, followed by oral calcium and calcitriol if it persists.

Option by option

  • A. Oral levothyroxine

    Levothyroxine replaces thyroid hormone and does not raise calcium.

  • B. Intravenous calcium gluconate (correct)

    Correct. Intravenous calcium rapidly corrects symptomatic hypocalcaemia and prevents laryngospasm.

  • C. Thiazide diuretic

    Thiazides reduce urinary calcium excretion and are too slow and unsuitable in an acute emergency.

  • D. Intravenous magnesium sulphate only

    Magnesium is useful only if there is coexisting hypomagnesaemia, and it is not the immediate treatment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Intravenous calcium gluconate. Transient hypoparathyroidism after thyroidectomy follows devascularisation or removal of parathyroid glands and typically presents at 24 to 72 hours.

Why is "Oral levothyroxine" not the answer?

Levothyroxine replaces thyroid hormone and does not raise calcium.

Why is "Thiazide diuretic" not the answer?

Thiazides reduce urinary calcium excretion and are too slow and unsuitable in an acute emergency.

Why is "Intravenous magnesium sulphate only" not the answer?

Magnesium is useful only if there is coexisting hypomagnesaemia, and it is not the immediate treatment.

What concept does this question test?

It tests Thyroid: hypocalcaemia in General Surgery. Symptomatic hypocalcaemia is an emergency treated with intravenous calcium gluconate, followed by oral calcium and calcitriol if it persists.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Thyroid: hypocalcaemia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.