Complications and emergencies: hypocalcaemia after thyroidectomy: practice question

A Anaesthesia 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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Anaesthesia · Complications and emergencies: hypocalcaemia after thyroidectomy

Sample item

On the second day after total thyroidectomy, a woman has perioral tingling, carpopedal spasm and a positive Chvostek sign. What is the most appropriate immediate treatment?

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

The answer and the reasoning

C. Intravenous calcium gluconate

Inadvertent removal or devascularisation of the parathyroid glands causes hypocalcaemia, with paraesthesia, tetany and sometimes laryngospasm. Symptomatic patients receive intravenous calcium gluconate, followed by oral calcium and vitamin D.

Option by option

  • A. Oral levothyroxine

    Levothyroxine replaces thyroid hormone and does not correct calcium.

  • B. Intravenous magnesium sulphate

    Magnesium would be given only if hypomagnesaemia coexists, and does not treat the calcium deficit.

  • C. Intravenous calcium gluconate (correct)

    Correct. Symptomatic hypocalcaemia is treated with intravenous calcium.

  • D. Intravenous hydrocortisone

    Hydrocortisone is not a treatment for hypocalcaemic tetany.

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 Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Intravenous calcium gluconate. Inadvertent removal or devascularisation of the parathyroid glands causes hypocalcaemia, with paraesthesia, tetany and sometimes laryngospasm.

Why is "Oral levothyroxine" not the answer?

Levothyroxine replaces thyroid hormone and does not correct calcium.

Why is "Intravenous magnesium sulphate" not the answer?

Magnesium would be given only if hypomagnesaemia coexists, and does not treat the calcium deficit.

Why is "Intravenous hydrocortisone" not the answer?

Hydrocortisone is not a treatment for hypocalcaemic tetany.

What concept does this question test?

It tests Complications and emergencies: hypocalcaemia after thyroidectomy in Anaesthesia. Symptomatic patients receive intravenous calcium gluconate, followed by oral calcium and vitamin D.

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 Complications and emergencies: hypocalcaemia after thyroidectomy?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.